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    Interventional procedure overview of image-guided percutaneous laser ablation of primary and secondary liver tumours

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    Outcome measures

    The main efficacy outcomes included complete tumour ablation, local tumour progression, local or distant recurrence, overall survival, and disease-free survival. Safety outcomes included mortality, bleeding, infection, and damage to surrounding tissues. The efficacy outcome measures used are detailed in the following paragraphs.

    The response evaluation criteria in solid tumours (RECIST) are used for measuring tumour response using X-ray, CT, and MRI. There are 4 categories:

    • complete response: disappearance of all target lesions

    • partial response: 30% decrease in the sum of the longest diameter of target lesions

    • progressive disease: 20% increase in the sum of the longest diameter of target lesions

    • stable disease: small changes that do not meet the above criteria.

    In modified RECIST (mRECIST) criteria, the response of target lesions is evaluated from the percentage change in the sum of the diameters of the viable portions (portions enhanced during the arterial phase).

    The World Health Organization criteria for tumour response assessment are:

    • complete response: disappearance of target tumour

    • partial response: more than 50% reduction in tumour size

    • no response or stable disease: less than 50% reduction in tumour size and less than 25% increase in tumour size

    • progressive disease: more than 25% increase in tumour size.

    Objective response is the aggregation of complete response and partial response results.

    The Child-Pugh scoring system (also known as the Child-Pugh-Turcotte score) was designed to predict mortality in people with cirrhosis. The score is determined by scoring 5 clinical measures of liver disease and the possibility of eventual liver failure. A score of 1, 2, or 3 is given to each measure, with 3 being the most severe. There are 3 categories according to the final score: A is the least severe, B indicates moderately severe liver disease and C is the most severe.