This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Interstitial laser coagulation with temporary hepatic artery occlusion for patients with cirrhosis and irresectable hepatoma. BJS 2003; 90: 950-955.

Published: 11th July 2003

Authors: C. Verhoef, J. W. Kuiper, J. Heisterkamp, R. A. de Man, P. M. T. Pattynama, J. N. M. IJzermans et al.

Background

The aim was to determine the degree of local control of hepatocellular carcinoma (HCC) in patients with cirrhotic liver disease when treated with ultrasonographically guided interstitial laser coagulation (ILC) with temporary hepatic artery occlusion.

Method

Sixteen patients with 24 HCC tumours were treated. Follow‐up was by computed tomography or magnetic resonance imaging every 3 months.

Results

Nineteen of 24 tumours showed complete necrosis immediately after treatment, and there was no tumour recurrence during follow‐up (mean 14 months, median 12 months). No effect on liver function was observed after 1 week and there was no death. In 13 of the 16 patients, new HCC foci developed at other sites.

Conclusion

Percutaneous ILC combined with temporary hepatic artery occlusion during a single session is an effective local treatment for HCC nodules smaller than 5 cm. However, new HCC lesions develop in the majority of patients, which underscores the need for adjuvant therapy or repeated treatment in these patients. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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