Claudio Maurizio Pacella MD, Abstract Co-Author: Nothing to Disclose

Giancarlo Bizzarri MD, Presenter: Nothing to Disclose

Dario Valle MD, Abstract Co-Author: Nothing to Disclose

Sara Pacella MD, Abstract Co-Author: Nothing to Disclose

Zaccaria Rossi MD, Abstract Co-Author: Nothing to Disclose

Roberto Stasi MD, Abstract Co-Author: Nothing to Disclose

Giampiero Francica MD, Abstract Co-Author: Nothing to Disclose

John Osborn PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To identify the factors that affect the achievement of tumor necrosis with percutaneous laser ablation (LA) in patients with hepatocellular carcinoma (HCC) and a tumor size ≤4.0 cm.

We retrospectively studied US-guided biopsy results in 99 lesions (range, 0.5-4.0 cm; mean, 2.7) performed on 82 patients (44 men, 38 women; age range, 50-80 years; median, 68) who had undergone LA.

A complete tumor ablation was obtained in 90 (90.9%) lesions. Of the 9 cases in which a complete tumor necrosis was not achieved, 6 were located in sites which did not allow the optimal placement of fibers, and 5 of these had a diameter >3 cm. Early discontinuation of LA due to decompensation of liver cirrhosis was the reason for not achieving a complete tumor ablation in 3 other cases. There was a clear relationship between the energy delivered and the volume of necrosis achieved (r=0.56; P< .001) regardless of the initial size of HCCs. The number of illuminations required, and consequently the amount of energy delivered, was also affected by tumor location. In fact, lesions adjacent to large vessels (3 mm or larger) required a higher number of illuminations than the other lesions to achieve a complete ablation (2.9± 1.4 vs. 2.3±0.9, P=0.043). The 8 cases with undifferentiated histology required more illuminations than the other histology types (3.4±0.9 vs. 2.2±0.9, P< .001). However, these cases were located in sites which did not allow the optimal placement of fibers, thus requiring multiple treatments.

LA is a highly effective treatment in HCCs with a size ≤4.0 cm. In this setting two variables, tumor size and tumor location, affect both the achievement of a complete tumor ablation and the number of treatments required to obtain tumor necrosis.

Pacella, C, Bizzarri, G, Valle, D, Pacella, S, Rossi, Z, Stasi, R, Francica, G, Osborn, J, et al, , Percutaneous Laser Ablation in the Treatment of Hepatocellular Carcinoma with a Tumor Size ≤ 4.0 cm: Analysis of Factors Affecting the Achievement of Tumor Necrosis.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4406072.html