Radiofrequency ablation of unresectable hepatic tumors

To evaluate the efficacy and safety of radiofrequency ablation (RFA) in the treatment of primary and metastatic liver malignancies.

Twenty-nine consecutive patients who have primary (n=9) and metastatic (n=20) liver malignancies were treated with RFA. The total number of lesions were 62 at the initiation of treatment and 28 new lesions were diagnosed at the follow-up period. Totally, 84 lesions were ablated with RFA technique at 46 sessions. Primary tumors that gave rise to metastatic lesion were all colorectal cancer except one with gallbladder carcinoma. The greatest tumor diameter immediately before treatment was 0.8-5 cm with a mean of 2.5 cm.

In the hepatocellular carcinoma (HCC) group, 1 patient was lost to follow-up, 5 deceased due to extensive disease, and 3 are still on the follow-up. In the metastatic liver disease group, 8 patients died due to progression of disease, 1 deceased due to stroke, and 3 were lost to follow-up. Nine patients with HCC had 14 nodules with a mean of 1.75 lesions/patient and 20 patients had 70 metastatic lesion with a mean of 3.1 lesions/patient. Residual viable neoplastic tissue was found at control computed tomography in 1 (1/14) lesion and recurrence occurred in 3 (3/14) lesions in HCC group. Recurrence occurred in 7 lesions (7/70) of 4 patients (4/20) in the metastatic liver disease group. Drainage requiring empyema took place in 1 patient and skin burn was observed in 2 as complications due to procedure.

RFA of primary and metastatic liver malignancies is a safe and effective tool for local control of disease in unresectable hepatic malignancies.