PURPOSE: To evaluate the safety, local effectiveness, and long-term results of laser\ud
thermal ablation (LTA) in the treatment of small hepatocellular carcinoma (HCC).\ud
MATERIALS AND METHODS: Ninety-two biopsies proved small HCCs (range,\ud
0.8–4.0 cm) in 74 patients who were treated percutaneously with LTA in an\ud
outpatient clinic. A laser at a power of 5.0Wwas coupled with one to four fibers that\ud
were advanced through 21-gauge needle(s) for 6–12 minutes. All lesions were\ud
evaluated with computed tomography (CT) for changes in size and vascular pattern,\ud
recurrence rates, and cumulative survival rates. Patients were examined for complications.\ud
RESULTS: No major complications occurred in 117 LTA sessions, with an average of\ud
1.3 sessions per tumor. At 3 months, CT scans showed a nonenhancing area\ud
(complete necrosis) in 89 (97%) of 92 lesions. During follow-up (range, 6–66\ud
months; mean, 25.3 months), 84 tumors (91%) decreased in size. The local recurrence\ud
rates (range, 1–5 years) ranged from 1.6% to 6.0%. Recurrence rates (range,\ud
12–60 months) in other liver segments ranged from 24% to 73%. Cancer-free\ud
survival rates (range, 1–4 years) ranged from 73% to 24%. Overall survival rates\ud
were 99%, 68%, and 15% at 1, 3, and 5 years, respectively. Twenty-one patients\ud
(28%) died.\ud
CONCLUSION: LTA is a safe and effective treatment for small HCC
Some procedural aspects of PEI treatment differ among the various centers a standardization is advisable. In the present survey PEI is a low-risk technique.
This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.