title: Preliminary results of ultrasound-guided laser ablation for unresectable metastases to retroperitoneal and hepatic portal lymph nodes.
abstract: BACKGROUND
  Laser ablation with a neodymium-doped yttrium aluminum garnet (Nd:YAG) laser is a minimally invasive approach which is able to achieve a precise tissue necrosis. The study was aimed to assess the feasibility and efficiency of laser ablation in the treatment of retroperitoneal and hepatic portal unresectable metastatic lymph nodes.
  
  
  METHODS
  Eight patients including 11 pathologically proven metastatic lymph nodes, 4 in retroperitoneal, 7 in hepatic portal region, were treated by laser ablation. Primary cancers were cholangiocarcinoma (n = 4) and hepatocellular carcinoma (n = 4). Under sonographic guidance, the laser ablation was performed percutaneously. Follow-up contrast computed tomography or magnetic resonance image was performed.
  
  
  RESULTS
  The treatments were completed in single process in all the patients. No severe complications occurred. Follow-up contrast computed tomography or magnetic resonance imaging at 1 and 3 months showed partial responses in 11 lymph nodes. The local response rate at the 6 month follow-up was 75.0 %. The overall response rate was 62.5 %. Abdominal pain scores decreased significantly in all patients. Tumor marker levels decreased in six patients. The Child-Pugh grade did not change.
  
  
  CONCLUSIONS
  The results suggest that sonographically guided laser ablation is technically feasible for the local treatment of unresectable retroperitoneal and hepatic portal lymph nodes from hepatic cancer. Although further study is needed to evaluate its long time efficacy, abdominal pain relief is prominent.
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Mou
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China.
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China.
authors.forename: Liyun
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China. chenmy69@126.com.
authors.forename: Tianan
authors.initials: T
authors.lastname: Jiang
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D014463:Ultrasonography / Q000379:methods*
keywords: Hepatic portal lymph node; Laser ablation; Metastasis; Retroperitoneal lymph node