Intraoperative radiofrequency ablation or cryoablation for hepatic malignancies

Area of Science:

• Hepatobiliary surgery
• Interventional oncology
• Minimally invasive tumor ablation

Background:

• Many patients with liver malignancies are ineligible for surgical resection due to tumor characteristics or compromised liver function.
• Cryoablation is used for unresectable liver tumors but is linked to considerable morbidity.
• Radiofrequency ablation (RFA) offers an alternative by using heat to induce coagulative necrosis in liver tumors.

Purpose of the Study:

• To compare complication rates between cryoablation and RFA for unresectable liver tumors.
• To evaluate and compare early local tumor recurrence rates following cryoablation versus RFA.
• To assess the safety and tolerability of RFA in patients with unresectable hepatic malignancies.

Main Methods:

• Prospective, nonrandomized trials involving patients with hepatic malignancies.
• Intraoperative treatment of liver tumors using either cryoablation or RFA, guided by intraoperative ultrasonography.
• Postoperative follow-up to monitor complications, treatment response, and local recurrence.

Main Results:

• Cryoablation treated 88 tumors in 54 patients, resulting in a 40.7% complication rate and 1 postoperative death.
• RFA treated 138 tumors in 92 patients, with a significantly lower complication rate of 3.3% and no treatment-related deaths (P<0.001).
• Early local tumor recurrence was observed in 13.6% of cryoablation cases versus 2.2% for RFA (P<0.01) after a median 15-month follow-up.

Conclusions:

• Radiofrequency ablation (RFA) is a safe and well-tolerated treatment for unresectable liver tumors.
• RFA demonstrates significantly lower complication rates compared to cryoablation for hepatic malignancies.
• RFA is associated with infrequent early local tumor recurrence, making it a favorable option.