628 Radiofrequency Ablation Versus Laser Ablation for the Treatment of Small Hepatocellular Carcinoma: A Randomized Controlled Trial

Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk

“…Even though LA has been less investigated than RFA and MWA, it is currently used in many centers to treat hepatocellular carcinoma (HCC) and liver metastases (LM), with very good results that are comparable to those of RFA and MWA for either HCC [8,34,35] or LM from colorectal cancer [10,11,36]. Moreover, no significant differences between LA and RFA in terms of local tumor control, overall survival, and safety were found in two randomized trials that compared the two techniques [13,35].…”

“…Even though LA has been less investigated than RFA and MWA, it is currently used in many centers to treat hepatocellular carcinoma (HCC) and liver metastases (LM), with very good results that are comparable to those of RFA and MWA for either HCC [8,34,35] or LM from colorectal cancer [10,11,36]. Moreover, no significant differences between LA and RFA in terms of local tumor control, overall survival, and safety were found in two randomized trials that compared the two techniques [13,35]. According to the multifiber technique [14,15], 300 lm bare optical fibers are introduced into the tumor through 21-gauge needles, and the possibility of using very thin needles makes LA particularly suitable for ablating lesions in an at-risk location or in locations that are difficult to reach [9,[16][17][18].…”

A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma

“…In our study, the treatment of cryoablation played a better role in the outcome of LTP at 1 year compared with microwave ablation and PEI and with similar OS and disease-free survival compared with RFA. Furthermore, the treatment of laser ablation has also been studied in recent years with almost similar efficacy compared to RFA, but with fewer complications [7,38,39]. However, the number of studies concerning laser ablation is not very large.…”

“…Those contained 11 treatment arms, namely, RFA, MWA, hepatic resection, PEI, laser ablation, cryoablation, RFA plus radiotherapy, RFA plus PEI, RFA plus TACE, RFA plus sorafenib and PEI plus TACE ( Figure 1). Among them, five studies compared the efficacy of RFA with MWA [20][21][22][23][24], seven studies compared the efficacy of RFA with hepatic resection [25][26][27][28][29][30][31], six RCTs compared the effects of RFA with PEI [32][33][34][35][36][37], three RCTs compared the effects of RFA versus laser ablation [7,38,39], only one study compared the effects of RFA versus cryoablation [6], two studies compared the effects of combined therapy of RFA plus 131 I radiotherapy versus RFA treatment alone [17,40], three studies compared the effects of RFA with RFA plus PEI [32,41,42] and four RCTs were enrolled that compared the effects of RFA combined with TACE to RFA alone [43][44][45][46]. Meanwhile, Huang et al compared the efficacy between hepatic resection and PEI [47], one study compared the effect of hepatic resection with RFA plus sorafenib [48] and one study compared hepatic resection with RFA plus TACE [49].…”

Role of ablation: should it be used as primary therapy for early-stage hepatocellular carcinoma?

“…None of the other thermal ablation techniques has been definitively shown to provide results better than RFA. Percutaneous laser ablation has had a limited diffusion and a recent prospective randomized trial comparing this technique with RFA in patients with early stage HCC did not show significant differences in terms of local tumor control and overall survival [4]. Microwave ablation has the theoretical advantage over RFA of shorter ablation session duration and better effectiveness in the treatment of HCC located near big vessels but no prospective randomized trials comparing RFA and MWA are currently available and no significant advantage for MWA-treated patients has been shown in retrospective series comparing this technique to RFA in patients with very early or early HCC [5].…”