title: Comparative evaluation of percutaneous laser and radiofrequency ablation in patients with HCC smaller than 4 cm.
abstract: OBJECTIVE
  This study was done to compare percutaneous laser ablation (PLA) and radiofrequency thermoablation (RFA) for the treatment of hepatocellular carcinoma (HCC) ≤ 4 cm, in patients with liver cirrhosis.
  
  
  METHODS
  Thirty patients with single HCC ≤ 4 cm in diameter were randomly assigned to one of two treatments: 15 patients were treated with PLA, using a multifibre system connected to a neodymium yttrium-aluminium-garnet laser source; 15 patients were treated with RFA, using an expandable needle electrode. Patients were followed up for up to 12 months.
  
  
  RESULTS
  A complete response was obtained in 87 % lesions treated with PLA and in 93 % lesions treated with RFA (p = ns). The overall local recurrence-free survival rates at 3, 6 and 12 months were comparable. However, a higher rate of recurrence was observed in the PLA group for lesions ≥ 21 mm (p = 0.0081). A postablation syndrome was documented in 13 patients (1 PLA; 12 RFA). Tumour necrosis factor-α was significantly higher in the RFA group (p < 0.05).
  
  
  CONCLUSIONS
  RFA is more effective in the treatment of HCC compared to PLA for lesions ≥ 21 mm. However, PLA should be considered a viable treatment option for HCC ≤ 20 mm, in view of the lower incidence of complications.
authors.affiliation: Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Policlinico Universitario "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy, aorlacchio@uniroma2.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Orlacchio
authors.forename: Francesca
authors.initials: F
authors.lastname: Bolacchi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Chegai
authors.forename: Alberto
authors.initials: A
authors.lastname: Bergamini
authors.forename: Elisa
authors.initials: E
authors.lastname: Costanzo
authors.forename: Costantino
authors.initials: C
authors.lastname: Del Giudice
authors.forename: Mario
authors.initials: M
authors.lastname: Angelico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Simonetti
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011846:Radio Waves; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D014409:Tumor Necrosis Factor-alpha