Comparative evaluation of percutaneous laser and radiofrequency ablation in patients with HCC smaller than 4 cm

Antonio Orlacchio, Francesca Bolacchi, Fabrizio Chegai, Alberto Bergamini, Elisa Costanzo, Costantino Del Giudice, Mario Angelico, Giovanni Simonetti

Research output: Contribution to journalArticlepeer-review


Objective: This study was done to compare percutaneous laser ablation (PLA) and radiofrequency thermoablation (RFA) for the treatment of hepatocellular carcinoma (HCC) ≤ 4 cm, in patients with liver cirrhosis. Materials and methods: Thirty patients with single HCC ≥4 cm in diameter were randomly assigned to one of two treatments: 15 patients were treated with PLA, using a multifibre system connected to a neodymium yttrium-aluminium-garnet laser source; 15 patients were treated with RFA, using an expandable needle electrode. Patients were followed up for up to 12 months. Results: A complete response was obtained in 87 % lesions treated with PLA and in 93 % lesions treated with RFA (p = ns). The overall local recurrence-free survival rates at 3, 6 and 12 months were comparable. However, a higher rate of recurrence was observed in the PLA group for lesions ≥21 mm (p = 0.0081). A postablation syndrome was documented in 13 patients (1 PLA; 12 RFA). Tumour necrosis factor-α was significantly higher in the RFA group (p <0.05). Conclusions: RFA is more effective in the treatment of HCC compared to PLA for lesions ≥21 mm. However, PLA should be considered a viable treatment option for HCC ≤20 mm, in view of the lower incidence of complications.

Original languageEnglish
Pages (from-to)298-308
Number of pages11
JournalRadiologia Medica
Issue number5
Publication statusPublished - 2014


  • Hepatocellular carcinoma
  • Liver cirrhosis
  • Percutaneous laser ablation
  • Radiofrequency thermoablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)


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