Radiofrequency ablation of malignant liver tumors

Introduction: Radio-frequency ablation (RFA) is a minimally invasive therapy for malignant liver tumours. In a pilot study, we evaluated the technique and its ability to achieve local tumour control. The treatments were performed either as a percutaneous procedure in inoperable patients or intraoperatively during partial hepatectomy to destroy unresectable metastases. Material and methods: Fourteen patients with liver metastases from colorectal (11) or endocrine (3) tumours were treated with cooled-needle electrode RFA. The electrodes were placed in the treated tumours under ultrasound guidance. Two patients were excluded from the study and in the remaining 12 patients, 52 metastases (7-50 mm in diameter) were treated in 26 sessions. Procedure efficacy was evaluated with contrast enhanced CT and ultrasound guided biopsy performed 1, 3, and 6 months after treatment. Results: Complete response was achieved in 89% of treated metastases, evaluated after a follow-up of 4-35 months (mean 15 months). Complications were seen in five of 26 treatment sessions, among these the most serious was a gall bladder fistula. Discussion: RFA appears to be a promising therapeutic modality in the treatment of hepatic malignancies. The clinical use of RFA has shown an ability to achieve local tumour control in about 90% of treated metastases. The patients treated were inoperable, but the nevertheless survival data are encouraging. The role of RFA as the treatment of choice has still to be tested against surgery in a large, prospective, randomised series with a long observational period. RFA is a commendable treatment, because of its minimal invasiveness, the low rate of complications, and the low cost.