Radiofrequency ablation of malignant hepatic neoplasms

To assess the safety and efficacy of radiofrequency ablation (RFA) in the treatment of malignant neoplasms of the liver.

Sixty-seven patients received RFA for primary or secondary hepatic malignancies. Patients were followed prospectively with computed tomography (CT) scanning to assess for therapeutic response, disease progression and complications.

Eighty-eight lesions were treated, including 57 hepatocellular carcinomas, 28 metastases, 2 cholangiocarcinomas and 1 hepatic plasmacytoma. Mean tumour size was 2.7 cm (range 0.5-6.9 cm). A total of 101 ablations were performed (66 percutaneously, 35 intraoperatively). Over a mean follow-up period of 142 days, results were available for 85 lesions. Local tumour control was achieved for 61 (72%) lesions, but new distant lesions developed in 6 of these cases. Residual disease was present in 20 (23%) lesions, and 4 (5%) lesions developed local recurrence. There were 10 complications, including 1 death in a patient who developed a liver abscess and subsequently died from hepatic failure.

RFA is safe and effective in the treatment of hepatic malignancies. Local tumour control can be achieved in most cases; however, careful surveillance is important for detecting recurrent disease, as well as new lesions distant from the treated site.