Radiofrequency ablation: A novel primary and adjunctive ablative techniquefor hepatic malignancies

The majority of primary and metastatic tumors of the liver are not amenable to surgical resection at presentation. Radiofrequency ablation (RFA) is a new modality for local tumor destruction with minimal local and systemic co mplications. We prospectively reviewed the experience with RFA at a single institute as a primary or adjunctive ablative technique in the treatment of hepatic malignancies. Between November 1997 and December 1998, 30 patients with primary or metastatic hepatic lesions were treated with RFA at the Jo hn Wayne Cancer Institute and the Cancer Center at Century City Hospital. P athology of the treated lesions included colorectal metastases (29 in 14 pa tients), neuroendocrine metastases (29 in 4 patients), noncolorectal metast ases (29 in 9 patients), and hepatocellular carcinoma (6 in 3 patients). Tw elve patients underwent RFA laparoscopically, 12 at celiotomy, and the rema ining 6 patients had percutaneous ablation. RFA was the only procedure in 1 7 patients, whereas the remainder underwent a combination of RFA and other procedures including resection, cryosurgical ablation, and hepatic artery i nfusion pump placement. Median length of stay for all patients was 6 days ( 2 days for laparoscopic patients). A single complication of a delayed intra hepatic abscess was noted in this series (3%). There have been no deaths as sociated with RFA. At a median follow-up of 5 months, 16 patients remain di sease free, and 10 are alive with disease. RFA is a safe and effective meth od of tumor ablation for hepatic malignancies. This technique dan be perfor med laparoscopically, at celiotomy, or percutaneously and can be used as a primary technique or in conjunction with other interventional procedures.