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Extracorporeal High Intensity Focused Ultrasound Ablation in the Treatment of Patients with Large Hepatocellular Carcinoma

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Abstract

Background: 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).

Methods: 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.

Results: 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 α-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).

Conclusion: 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.

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Authors and Affiliations

  1. Institute of Ultrasonic Engineering in Medicine, and Clinical Center for Tumor Therapy of 2nd Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, China

    Feng Wu MD, PhD, Zhi-Biao Wang MD, PhD, Wen-Zhi Chen MD, Hui Zhu MD, Jin Bai MD, Jian-Zhong Zou MD, Ke-Quan Li MD, Cheng-Bing Jin MD, Fang-Lin Xie MD & Hai-Bing Su MD

  2. Chongqing University of Medical Sciences, Box 153, Institute of Ultrasonic Engineering in Medicine, 1 Medical College Road, Chongqing, 400016, China

    Feng Wu MD, PhD

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  1. Feng Wu MD, PhD
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  2. Zhi-Biao Wang MD, PhD
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  3. Wen-Zhi Chen MD
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Correspondence to Feng Wu MD, PhD.

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Wu, F., Wang, ZB., Chen, WZ. et al. Extracorporeal High Intensity Focused Ultrasound Ablation in the Treatment of Patients with Large Hepatocellular Carcinoma. Ann Surg Oncol 11, 1061–1069 (2004). https://doi.org/10.1245/ASO.2004.02.026

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  • DOI: https://doi.org/10.1245/ASO.2004.02.026

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