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Title: Interstitial laser thermotherapy for liver tumours.
Austin Authors: Nikfarjam, Mehrdad ;Christophi, Christopher 
Affiliation: Department of Surgery, University of Melbourne, Austin Hospital, LTB 8, Studley Road, Heidelberg, Melbourne, Victoria 3084, Australia
Issue Date: 1-Sep-2003
Publication information: The British Journal of Surgery; 90(9): 1033-47
Abstract: Primary hepatocellular carcinoma (HCC) and metastases from colorectal cancer are the most common malignant liver tumours. Surgical resection is the optimum treatment in suitable patients. Interstitial laser thermotherapy (ILT) is gaining acceptance for the treatment of irresectable liver tumours and as a potential alternative to surgery. An understanding of the principles of therapy and review of clinical outcomes may allow better use of this technology.An electronic search using the Medline database was performed for studies on the treatment of hepatic malignancy published between January 1983 and February 2003.Current information on the efficacy of ILT is based on prospective studies. ILT appears to be a safe and minimally invasive technique that consistently achieves tumour destruction. The extent of destruction depends on the fibre design, delivery system, tumour size and tumour biology. Real-time magnetic resonance imaging provides the most accurate assessment of laser-induced tumour necrosis. In selected patients with HCC and colorectal cancer liver metastases, ILT achieves complete tumour necrosis, provides long-term local control, and improves survival, compared with the natural history of the disease. In addition, ILT has survival benefits for patients with other tumour types, especially those with isolated liver metastases from a breast cancer primary.ILT improves overall survival in specific patients with liver tumours. Advances in laser technology and refinements in technique, and a better understanding of the processes involved in laser-induced tissue injury, may allow ILT to replace surgery as the procedure of choice in selected patients with liver malignancies.
Gov't Doc #: 12945069
DOI: 10.1002/bjs.4326
Journal: The British journal of surgery
Type: Journal Article
Subjects: Breast
Colorectal Neoplasms
Equipment Design
Laser Therapy.adverse effects.instrumentation.methods
Magnetic Resonance Imaging
Patient Selection
Radiography, Interventional
Survival Analysis
Ultrasonography, Interventional
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