Focused ultrasound kills big liver tumors

Focused ultrasound can cook a lot more than uterine fibroids. The ablation technique is also safe and effective treating large hepatocellular carcinomas, according to papers presented Wednesday.

From March 1998 to October 2001, Dr. Feng Wu and colleagues at the University of Medical Sciences in China enrolled 61 prospective patients with HCC into a nonrandomized trial to test ultrasound-guided focused ablation. The investigators found the technique was safe, effective, and feasible for the treatment of lesions up to 14 cm in diameter.

Six patients underwent focused ultrasound ablation prior to surgical resection for pathological study. The remaining 55 underwent ablation and follow-up for long-term efficacy evaluation. Fifty-one patients in this group had unresectable HCC with a mean diameter of 8.14 cm (size range, 4 to 14 cm).

The pathological examination showed that focused ultrasound eliminated the targeted HCC and severely damaged the tumors' vascular vessels smaller than 2 mm in diameter. Follow-up confirmed the absence of tumor vascular supply and lesion regression.

Twenty-three patients were still alive after a median follow-up of 18 months. The overall survival rates recorded at six, 12, and 18 months were 86.1%, 61.5%, and 35.3%, respectively. The survival rates were significantly higher in stage II tumor patients than stage III and IV.

Focused ultrasound ablation is safe, effective, and feasible, and it should also be considered as a palliative treatment in patients with advanced stage malignancies of the liver, Wu said.

In a different study discussing focused ultrasound, Boston researchers presented results of a trial designed to determine whether menstrual cycle phase determines treatment success.

Dr. Minna So and colleagues at Massachusetts General Hospital enrolled 58 patients with uterine fibroids. They confirmed the phase of the menstrual cycle does not affect treatment outcome.

Researchers divided patients into two groups: One group underwent focused ultrasound during the proliferative phase of the menstrual cycle, and the other group during the secretory phase. Each group included similar number of uterine leiomyomas.

Symptomatic improvement occurs at any phase of the cycle, So said.