Radiofrequency ablation in hepatic metastases - technique and first results

Primary and secondary malignant hepatic tumors are the most common tumors w ith a much more higher incidence of hepatic metastases. Chemotherapy and ra diation therapy are in general ineffective. Therefore, surgical resection i s considered the method of choice in the treatment of malignant hepatic les ions. Due to systemic disease, general medical or procedure-related reasons hindering surgery, only 25 to 45% of the patients with metastatic disease of the liver are suitable for a curative surgical therapy. In resectable lesions thermoablative methods can offer an alternative to th e surgical therapy. The most experience exists in radiofrequency ablation t echniques. Technique, indications, contraindications,and limitations of the radiofrequ ency ablation will be discussed together with a presentation of own cases a nd a review of the literature. In 37 patients the primary technical success rate of the ablation was 97.3% (72 of 74 lesions). In 4 cases a hematoma of the liver capsule occurred. O ne of these had to be treated interventionally. During the limited follow-u p period of 9 months no local recurrency was seen, however 4 patients devel oped new hepatic metastases. Beside differences in practicability it is not yet clarified if there are d ifferences in the therapeutic efficacy of the different thermoablation meth ods. Nevertheless, the results of the ablation therapy may parallel the res ults of the surgical resection. Interstitial thermotherapy can provide a va luable contribution to local tumor control. However, the final significance of the thermoablation techniques within oncological therapy regimens has t o be evaluated in further multidisciplinary studies.