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document
Comparative evaluation of percutaneous laser and radiofrequency ablation in patients with HCC smaller than 4 cm . OBJECTIVE This study was done to compare percutaneous laser ablation ( PLA ) and radiofrequency thermoablation ( RFA ) for the treatment of hepatocellular carcinoma ( HCC ) ≤ 4 cm , in patients with liver cirrhosis . MATERIALS AND METHODS Thirty patients with single HCC ≤ 4 cm in diameter were randomly assigned to one of two treatments : 15 patients were treated with PLA , using a multifibre system connected to a neodymium yttrium-aluminium-garnet laser source ; 15 patients were treated with RFA , using an expandable needle electrode . Patients were followed up for up to 12 months . RESULTS A complete response was obtained in 87 % lesions treated with PLA and in 93 % lesions treated with RFA ( p = ns ) . The overall local recurrence-free survival rates at 3 , 6 and 12 months were comparable . However , a higher rate of recurrence was observed in the PLA group for lesions ≥ 21 mm ( p = 0.0081 ) . A postablation syndrome was documented in 13 patients ( 1 PLA ; 12 RFA ) . Tumour necrosis factor-α was significantly higher in the RFA group ( p < 0.05 ) . CONCLUSIONS RFA is more effective in the treatment of HCC compared to PLA for lesions ≥ 21 mm . However , PLA should be considered a viable treatment option for HCC ≤ 20 mm , in view of the lower incidence of complications .
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Intervention_Surgical
percutaneous laser
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Intervention_Surgical
radiofrequency ablation
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Intervention_Surgical
percutaneous laser ablation ( PLA )
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Intervention_Surgical
radiofrequency thermoablation ( RFA )
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Outcome_Mortality
overall local recurrence-free survival rates
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Outcome_Other
rate of recurrence
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Outcome_Adverse-effects
postablation syndrome
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Outcome_Physical
Tumour necrosis factor-α
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Participant_Condition
HCC
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Participant_Condition
hepatocellular carcinoma
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Participant_Condition
liver cirrhosis