Clinical

Laser ablation may be better than surgery for some liver cancers

Last Updated: 2005-11-29 15:28:19 -0400 (Reuters Health)

By M. Mary Conroy

CHICAGO (Reuters Health) - Magnetic resonance-guided laser-induced thermotherapy (LITT) for treatment of both primary and metastatic liver tumors improves survival with less morbidity compared to standard surgical resection, researchers reported Tuesday at the annual meeting of the Radiological Society of North America.

Dr. Martin Mack, associate professor of diagnostic and interventional radiology at the University of Frankfort, Germany reported results from a series of 839 patients, mean age 62, who underwent LITT over a 12-year period.

The operative mortality rate was just 0.2% for the LITT patients compared with an historical mortality rate of 3%-4% for patients who undergo open-surgical resections, Dr. Mack said. Likewise, post-procedural complications were much lower: 2% among LITT patients versus 30% in historical controls.

"Those who undergo surgery have a median survival of 3.4 to 4.5 years, but patients who undergo ablation treatment have a median survival of around 5 years," reported Dr. Mack in a press briefing. He said that LITT can also be repeated several times in the event of recurrences.

The LITT procedure involves MRI to precisely locate a tumor and then guide a laser probe into the tumor. Laser energy destroys the lesion. Dr. Mack said the procedure is equally effective for primary liver tumors or metastases.

LITT is, however, limited by both the number of lesions and the size of the tumors. Ideally patients should have no more than five lesions, each 5 cm or less. For patients with larger tumors or more lesions, he recommended staging with chemotherapy or chemoembolization prior to LITT.

Unlike surgical resection, which can require a week or more hospital stay, LITT patients are typically discharged within 6 hours. "It can be performed on an outpatient basis," Dr. Mack said.

Cost comparisons also favor LITT, "with each ablation costing about $5,000-$6,000 versus $30,000 for surgery and chemotherapy averaging $3,000 to $5,000 a month with treatment continuing over several months," he said.