RF Ablation Minimally Invasive Alternative for Liver Cancer

The downside of this procedure, however, is that most patients do not meet the surgical requirements. Liver transplantations can be performed on only a small number of patients, organ supply is limited, and tumor progression during the long waiting times results in a high dropout rate. As a result, RF ablation has become an alternative treatment option for inoperable liver cancer, and may be useful as a bridge to liver transplantation. RF ablation is a minimally invasive procedure where an interventional radiologist used an image-guided electrode needle to deliver heat directly to the tumor, essentially "cooking” it.

In the first study, Dr. Lencioni and coworkers performed RF ablation on 187 early-stage cancer patients with cirrhosis who are not eligible for surgery. Individuals with hepatitis B, C, or cirrhosis are at increased risk of developing liver cancer. Less than 5% of liver-cancer patients with cirrhosis are eligible for surgical liver resection. "RF ablation was shown to be a safe therapeutic option, with no treatment-induced mortality and a complication rate below 2%,” Dr. Lencioni said.

After one year, 97% of the patients survived, 71% survived after three years, and 48% survived after five years, which is comparable to results obtained with surgical resection in this kind of patient. The findings also indicate that patient survival with RF ablation is dependent on the type of cirrhosis and number of tumors present.

"The results that we have reported are very promising,” Dr. Lencioni said. "However, they can only be obtained when the diagnosis of liver cancer is made at an early, asymptomatic stage. It is of the utmost importance that all patients with chronic hepatitis or cirrhosis--who are known to be at risk to develop liver cancer--are carefully monitored for timely detection of the emergence of a tumor.”

The second study published in Radiology additionally shows the effectiveness of RF ablation in treating liver tumors. "We have unequivocally demonstrated that RF ablation is highly capable of complete tumor destruction for small liver cancer nodules,” said David S.K. Lu, M.D., professor of radiology and director of the image-guided tumor ablation program at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA: CA, USA).

In this study, UCLA investigators used RF ablation to treat 47 liver cancer nodules in 24 patients who were waiting for liver transplantation. After transplantation, pathologic examinations of the diseased livers were performed to retrospectively assess the effectiveness of RF. The researchers found that 74% of the tumors were effectively treated by ablation. The procedure was more successful with smaller tumors than with larger tumors, with a success rate of 83% when treating tumors 3 cm or smaller.

According to Dr. Lu, not all tumors can be treated in this way. "It is important to discuss treatment options with a hepatologist or oncologist and to seek consultation with an interventional radiologist experienced in tumor ablation,” he said.



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