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- W2343207188 abstract "Aims: The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are operative candidates. Percutaneous radiofrequency interstitial thermal ablation proved to be effective, too. Our objective was to assess an operative combination of laparoscopic ultrasound with laparoscopic ablation therapies (LATs) in the treatment of HCC not amenable to liver resection. Methods: Four hundred and twenty-six patients with HCC in liver cirrhosis were submitted to LATs. LATs were indicated in patients not amenable to liver resection that had at least one of the following criteria: a) severe impairment of the coagulation tests; b) large tumors (but < 5 cm) or multiple lesions requiring repeated punctures; c) superficial lesions adjacent to visceral structures; d) deep-sited lesions with a very difficult or impossible percutaneous approach; e) short-term recurrence of HCC following percutaneous loco-regional therapies. Results: LATs were completed in 424 out of 426 patients (98% feasibility rate). Laparoscopic ultrasound identified 25% of new malignant lesions undetected by preoperative imaging. Three hundred and twenty patients had no complication (75%). At 1-month computed tomography (CT) evaluation, a complete response with a 100% necrosis was achieved in 396 out of 426 patients (93%). Thirty-day hospital mortality occurred in 1 patient due to cardiac failure, (0.24%). During the follow-up (mean 37.2 months, range 2–193 months), 276 patients (65%) developed intrahepatic recurrence of which 65 (15%) characterized as local tumour progression. Patients survived a median 39 months 95% CI: 34.8–47.2), and overall survival at 1, 3, and 5 years was 88%, 55%, and 34% respectively. Conclusions: LATs of HCC proved to be a safe and effective technique at least in the short and mid-term: in fact it permits to detect 25% of new HCC nodules and to treat lesions not suitable to percutaneous approach with a low morbidity rate." @default.
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- W2343207188 date "2016-04-01" @default.
- W2343207188 modified "2023-10-04" @default.
- W2343207188 title "Laparoscopic Ablation Therapies For Hepatocellular Carcinoma: Indication, Technique And Long-Term Results" @default.
- W2343207188 doi "https://doi.org/10.1016/j.hpb.2016.01.131" @default.
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