Laser thermal ablation in the treatment of small hepatocellular carcinoma:Results in 74 patients

PURPOSE: To evaluate the safety, local effectiveness, and long-term results of laser thermal ablation (LTA) in the treatment of small hepatocellular c arcinoma (HCC). MATERIALS AND METHODS: Ninety-two biopsies proved small HCCs (range, 0.8-4. 0 cm) in 74 patients who were treated percutaneously with LTA in an outpati ent clinic. A laser at a power of 5.0 W was coupled with one to four fibers that were advanced through 21-gauge needle(s) for 6-12 minutes. All lesion s were evaluated with computed tomography (CT) for changes in size and vasc ular pattern, recurrence rates, and cumulative survival rates. Patients wer e examined for complications. RESULTS: No major complications occurred in 117 LTA sessions, with an avera ge of 1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing a rea (complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6-66 months; mean, 25.3 months), 84 tumors (91%) decreased in size. The lo cal recurrence rates (range, 1-5 years) ranged from 1.6% to 6.0%. Recurrenc e rates (range, 12-60 months) in other liver segments ranged from 24% to 73 %. Cancer-free survival rates (range, 1-4 years) ranged from 73% to 24%. Ov erall survival rates were 99%, 68%, and 15% at 1, 3, and 5 years, respectiv ely. Twenty-one patients (28%) died. CONCLUSION: LTA is a safe and effective treatment for small HCC.