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Published in: European Radiology 9/2010

01-09-2010 | Interventional

Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results

Authors: Bruno Caspani, Anna Maria Ierardi, Fabio Motta, Piero Cecconi, Edoardo Fesce, Luca Belli

Published in: European Radiology | Issue 9/2010

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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”.
Literature
1.
go back to reference Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304CrossRefPubMed Makuuchi M, Kosuge T, Takayama T et al (1993) Surgery for small liver cancers. Semin Surg Oncol 9:298–304CrossRefPubMed
2.
go back to reference 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 334:693–699CrossRef 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 334:693–699CrossRef
3.
go back to reference Llovet JM, Fuster J, Bruix J et al (1999) Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440CrossRefPubMed Llovet JM, Fuster J, Bruix J et al (1999) Intention to treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 30:1434–1440CrossRefPubMed
4.
go back to reference Livraghi T, Giorgio A, Marin G et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology 197:101–108PubMed Livraghi T, Giorgio A, Marin G et al (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology 197:101–108PubMed
5.
go back to reference Ishii H, Okada S, Nose H et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77:1792–1796CrossRefPubMed Ishii H, Okada S, Nose H et al (1996) Local recurrence of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 77:1792–1796CrossRefPubMed
6.
go back to reference 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 160:1023–1028PubMed 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 160:1023–1028PubMed
7.
go back to reference Ishii H, Okada S, Okusaka T et al (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642CrossRefPubMed Ishii H, Okada S, Okusaka T et al (1998) Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection. Cancer 82:1638–1642CrossRefPubMed
8.
go back to reference Yamashita Y, Matsukawa T, Arakawa A et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804PubMed Yamashita Y, Matsukawa T, Arakawa A et al (1995) US-guided liver biopsy: predicting the effect of interventional treatment of hepatocellular carcinoma. Radiology 196:799–804PubMed
9.
go back to reference Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radiofrequency ablation versus ethanol injection. Radiology 210:655–661PubMed Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radiofrequency ablation versus ethanol injection. Radiology 210:655–661PubMed
10.
go back to reference Murakami R, Yoshimatsu S, Yamashita Y et al (1995) Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR Am J Roentgenol 164:1159–1164PubMed Murakami R, Yoshimatsu S, Yamashita Y et al (1995) Treatment of hepatocellular carcinoma: value of percutaneous microwave coagulation. AJR Am J Roentgenol 164:1159–1164PubMed
11.
go back to reference Pacella CM, Bizzarri G, Ferrari FS et al (1996) Interstitial photocoagulation with laser in the treatment of liver metastases. Radiol Med 92:438–447PubMed Pacella CM, Bizzarri G, Ferrari FS et al (1996) Interstitial photocoagulation with laser in the treatment of liver metastases. Radiol Med 92:438–447PubMed
12.
go back to reference Silvermann SG, Tuncali K, Adams DF et al (2000) MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience. Radiology 217:657–664 Silvermann SG, Tuncali K, Adams DF et al (2000) MR imaging-guided percutaneous cryotherapy of liver tumors: initial experience. Radiology 217:657–664
13.
go back to reference 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 11:1061–1069CrossRef 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 11:1061–1069CrossRef
14.
go back to reference Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high risk locations. Hepatology 43:1101–1108CrossRefPubMed Teratani T, Yoshida H, Shiina S et al (2006) Radiofrequency ablation for hepatocellular carcinoma in so-called high risk locations. Hepatology 43:1101–1108CrossRefPubMed
15.
go back to reference Sutherland LM, Williams JAR, Padbury RTA et al (2006) Radiofrequency ablation of liver tumors. Arch Surg 141:181–190CrossRefPubMed Sutherland LM, Williams JAR, Padbury RTA et al (2006) Radiofrequency ablation of liver tumors. Arch Surg 141:181–190CrossRefPubMed
16.
go back to reference Arienti V, Pretolani S, Pacella CM et al (2008) Complications of laser ablation for hepatocellular carcinoma: a multicentre study. Radiology 246:947–955CrossRefPubMed Arienti V, Pretolani S, Pacella CM et al (2008) Complications of laser ablation for hepatocellular carcinoma: a multicentre study. Radiology 246:947–955CrossRefPubMed
17.
go back to reference Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol 35:421–430CrossRefPubMed Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol 35:421–430CrossRefPubMed
18.
go back to reference Pacella CM, Bizzarri C, Magnolfi F et al (2001) Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 221:712–720CrossRefPubMed Pacella CM, Bizzarri C, Magnolfi F et al (2001) Laser thermal ablation in the treatment of small hepatocellular carcinoma: results in 74 patients. Radiology 221:712–720CrossRefPubMed
19.
go back to reference Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumour ablation: standardization of terminology and reporting criteria. Radiology 235:728–739CrossRefPubMed Goldberg SN, Grassi CJ, Cardella JF et al (2005) Image-guided tumour ablation: standardization of terminology and reporting criteria. Radiology 235:728–739CrossRefPubMed
20.
go back to reference 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 217:119–126PubMed 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 217:119–126PubMed
21.
go back to reference Whelan WM, Wyman DR, Wilson BC (1995) Investigations of large vessel cooling during interstitial laser heating. Med Phys 22:105–115CrossRefPubMed Whelan WM, Wyman DR, Wilson BC (1995) Investigations of large vessel cooling during interstitial laser heating. Med Phys 22:105–115CrossRefPubMed
22.
go back to reference Ghough-Palmer AL, Gedroyc WMW (2008) Laser ablation of hepatocellular carcinoma—a review. World J Gastroenterol 14:7170–7174CrossRef Ghough-Palmer AL, Gedroyc WMW (2008) Laser ablation of hepatocellular carcinoma—a review. World J Gastroenterol 14:7170–7174CrossRef
23.
go back to reference 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 23:194–203CrossRefPubMed 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 23:194–203CrossRefPubMed
24.
go back to reference 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 226:441–451CrossRefPubMed 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 226:441–451CrossRefPubMed
25.
go back to reference Tateishi R, Shiina S, Teratani T et al (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma. Cancer 103:1201–1209CrossRefPubMed Tateishi R, Shiina S, Teratani T et al (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma. Cancer 103:1201–1209CrossRefPubMed
26.
go back to reference 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 16:353–357CrossRefPubMed 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 16:353–357CrossRefPubMed
Metadata
Title
Small nodular hepatocellular carcinoma treated by laser thermal ablation in high risk locations: preliminary results
Authors
Bruno Caspani
Anna Maria Ierardi
Fabio Motta
Piero Cecconi
Edoardo Fesce
Luca Belli
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 9/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1766-y

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