Laser-induced interstitial thermotherapy (LITT) of liver lesions - technique and application data-clinical data

The liver plays a central role in the human metabolism and so represents one of the organ systems most often affected, especially by tumorous diseases. The group of colorectal carcinomas metastatically almost exclusively attacks this organ, which, according to studies by Weiss et al., can be attributed to the venous drainage of the intestines through the portal vein [1,2]. A large number of primary tumors often cause liver metastases as well as bone, lung and brain metastases. After curative treatment of the primary tumor, the liver infestation has a decisive influence on the survival time of affected patients in many cases. The therapeutic strategy for malignant liver lesions is based on a number of factors such as the underlying primary tumor, localization, the stage the tumor has reached, and general factors, such as age or any existing concomitant disease. Surgical resection is well established in the treatment of liver metastases of colorectal carcinoma, typically yielding 5year survival rates between 25% and 38%. Two thirds of the patients will experience recurrent metastases, and many patients do not benefit from surgery. Data published from studies investigating the efficacy of surgical resection of liver metastases show 1-year survival rates between 71% and 88%, 3-year survival rates between 21% and 46%, and mean survival rates between 25 and 35 months. Perioperative mortality ranges from 4.4% to 10. In the case of hepatocellular carcinoma [3], when the tumor is at an appropriate stage, liver resection or hemihepatic resection or liver transplant are the essential curative treatment methods [4]. If there are contraindications, transarterial chemoembolization [5-8] combined with a local alcohol injection is used as a palliative therapeutic strategy [9-15]. Interstitial procedures such as laser-induced thermotherapy (LITT) or radio-frequency ablation show a high rate of controlling the site of the tumor and are currently clinically evaluated.