Abstract
Objectives
To demonstrate the effectiveness and the safety of laser thermal ablation (LTA) in patients with unresectable hepatocellular carcinoma (HCC) deemed not accessible for other percutaneous procedures (radiofrequency ablation, sclerotherapy).
Methods
From September 2003 to August 2008, 140 patients with HCC nodules were treated. In 49 patients, the lesions were localized in “critical sites”. A total of 29 men and 20 women (age range 51–79 years; Child–Pugh score A = 75.51%, B = 24.49%) with 52 nodules (mean diameter 2.0 ± 1.2 cm) were treated in 95 percutaneous LTA sessions. We compared major and minor complications observed in the two groups of patients. Effectiveness was defined as the percentage of HCCs completely ablated after percutaneous LTA. Follow-up was carried out with computed tomography (CT) at 1, 3, 6, 9, and 12 months.
Results
No major complications or deaths were registered. In a few patients (8.16%), minor complications were observed. No substantial differences were observed on comparing the percentage of minor and major complications in these patients with the remaining patients. A difference in terms of effectiveness was found.
Conclusion
LTA can be considered a safe treatment in “critical nodules”.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304
Mazzaferro V, Ragalia E, Doci R et al (1996) Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Eng J Med 334:693–699
Llovet JM, Fuster J, Bruix J et al (1999) Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440
Livraghi T, Giorgio A, Marin G et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology 197:101–108
Ishii H, Okada S, Nose H et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77:1792–1796
Shiina S, Tagawa K, Niwa Y et al (1993) Percutaneous ethanol injection therapy for the treatment of hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol 160:1023–1028
Ishii H, Okada S, Okusaka T et al (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642
Yamashita Y, Matsukawa T, Arakawa A et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804
Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radiofrequency ablation versus ethanol injection. Radiology 210:655–661
Murakami R, Yoshimatsu S, Yamashita Y et al (1995) Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR Am J Roentgenol 164:1159–1164
Pacella CM, Bizzarri G, Ferrari FS et al (1996) Interstitial photocoagulation with laser in the treatment of liver metastases. Radiol Med 92:438–447
Silvermann SG, Tuncali K, Adams DF et al (2000) MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience. Radiology 217:657–664
Wu F, Wang ZB, Chen WZ et al (2004) Extracorporeal high intensity focused untrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Onc 11:1061–1069
Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high risk locations. Hepatology 43:1101–1108
Sutherland LM, Williams JAR, Padbury RTA et al (2006) Radiofrequency ablation of liver tumors. Arch Surg 141:181–190
Arienti V, Pretolani S, Pacella CM et al (2008) Complications of laser ablation for hepatocellular carcinoma: a multicentre study. Radiology 246:947–955
Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol 35:421–430
Pacella CM, Bizzarri C, Magnolfi F et al (2001) Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 221:712–720
Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumour ablation: standardization of terminology and reporting criteria. Radiology 235:728–739
Rossi S, Garbagnati F, Lencioni R et al (2000) Percutaneous radiofrequency thermal ablation of non resectable hepatocellular carcinoma after occlusion of tumour blood supply. Radiology 217:119–126
Whelan WM, Wyman DR, Wilson BC (1995) Investigations of large vessel cooling during interstitial laser heating. Med Phys 22:105–115
Ghough-Palmer AL, Gedroyc WMW (2008) Laser ablation of hepatocellular carcinoma—a review. World J Gastroenterol 14:7170–7174
Germer CT, Roggan A, Ritz JP et al (1998) Optical properties of native and coagulated human liver tissue and liver metastases in the near infrared range. Lasers Surg Med 23:194–203
Livraghi T, Solbiati L, Meloni MF et al (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications in a multicentric study. Radiology 226:441–451
Tateishi R, Shiina S, Teratani T et al (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma. Cancer 103:1201–1209
Vilana R, Bruix J, Bru C et al (1992) Tumor size determines the efficacy of percutaneous injection for the treatment of small hepatocellular carcinoma. Hepatology 16:353–357
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Caspani, B., Ierardi, A.M., Motta, F. et al. Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results. Eur Radiol 20, 2286–2292 (2010). https://doi.org/10.1007/s00330-010-1766-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-010-1766-y