Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma

High intensity focused ultrasound (HIFU) is a noninvasive treatment modality that induces complete coagulative necrosis of a deep tumor through the intact skin. The current study was conducted to determine the safety, efficacy, and feasibility of extracorporeal HIFU in the treatment of patients with...

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Bibliographic Details
Published in:Annals of surgical oncology 2004-12, Vol.11 (12), p.1061-1069
Main Authors: Wu, Feng, Wang, Zhi-Biao, Chen, Wen-Zhi, Zhu, Hui, Bai, Jin, Zou, Jian-Zhong, Li, Ke-Quan, Jin, Cheng-Bing, Xie, Fang-Lin, Su, Hai-Bing
Format: Article
Language:English
Subjects:
Adult
Aged
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Female
Humans
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
Middle Aged
Necrosis
Prospective Studies
Survival Analysis
Treatment Outcome
Ultrasonic Therapy - adverse effects
Ultrasonic Therapy - methods
Ultrasonography
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Summary:High intensity focused ultrasound (HIFU) is a noninvasive treatment modality that induces complete coagulative necrosis of a deep tumor through the intact skin. The current study was conducted to determine the safety, efficacy, and feasibility of extracorporeal HIFU in the treatment of patients with hepatocellular carcinoma (HCC). A total of 55 patients with HCC with cirrhosis were enrolled in this prospective, nonrandomized clinical trial. Among them, 51 patients had unresectable HCC. Tumor size ranged from 4 to 14 cm in diameter with mean diameter of 8.14 cm. According to tumor, node, metastasis (TNM) classification, 15 patients corresponded to stage II, 16 to stage IIIA, and 24 to IIIC. All patients had HIFU, and the median number of HIFU session was 1.69. Safety and efficacy of HIFU were assessed in this trial. No severe side effect was observed in the patients treated with HIFU. Follow-up imaging showed an absence of tumor vascular supply and the shrinkage of treated lesions. Serum alpha-fetoprotein returned to normal level in 34% of patients. The overall survival rates at 6, 12, and 18 months were 86.1%, 61.5%, and 35.3%, respectively. The survival rates were significantly higher in patients in stage II than those in stage IIIA (P = .0132) and in stage IIIC (P = .0265). As a noninvasive therapy, HIFU appears to be effective, safe, and feasible in the treatment of patients with HCC. It may play an important role in the ablation of large tumors.
ISSN:1068-9265
1534-4681
DOI:10.1245/ASO.2004.02.026