Abstract
Background: Radiofrequency ablation (RFA) is being used to treat primary and metastatic liver tumors. The indications, treatment planning, and limitations of hepatic RFA must be defined and refined by surgeons treating hepatic malignancies.
Methods: A review of the experience using RFA to treat unresectable primary and secondary hepatic malignancies at the University of Texas M. D. Anderson Cancer Center in Houston, Texas, and the G. Pascale National Cancer Institute in Naples, Italy, is provided. Patient selection, treatment approach, local recurrence rates, and overall cancer recurrence rates following RFA are described. The current literature on RFA of hepatic malignancies is reviewed.
Results: RFA of hepatic tumors can be performed percutaneously, laparoscopically, or during an open surgical procedure. Incomplete treatment manifest as local recurrence is more common with a percutaneous approach. The morbidity and mortality rates associated with hepatic RFA are low. Local recurrence rates are low if meticulous treatment planning is performed. RFA can be combined safely with partial hepatic resection of large lesions. The long-term survival rates following RFA of primary and metastatic liver tumors have not yet been established.
Conclusions: RFA of hepatic malignancies is a safe and promising technique to produce coagulative necrosis of unresectable hepatic malignancies. Experience with this treatment modality is not yet mature enough to establish long-term outcomes.
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REFERENCES
LeVeen RF. Laser hyperthermia and radiofrequency ablation of hepatic lesions. Semin Interven Radiol 1997;14:313–24.
Dickson JA, Calderwood SK. Temperature range and selective sensitivity of tumors to hyperthermia: a critical review. Ann N Y Acad Sci 1980;335:180–205.
Hill RP, Hunt JW. Hyperthermia Tannock IF, Hill RP Eds. The Basic Science of Oncology. New York: Pergamon Press, 1987: 337–57.
Haines DE, Watson DD, Halperin C. Characteristics of heat transfer and determination of temperature gradient and viability threshold during radiofrequency fulguration of isolated perfused canine right ventricle. Circulation 1987;76:278–82.
Grundfest WS, Litvack FI, Doyle DL. Laser-tissue interactions: considerations for cardiovascular applications White RA, Grundfest WS Eds. Lasers in Cardiovascular Disease. Chicago: Yearbook Medical Publishers, 1987: 32–43.
Bischof J, Christov K, Rubinsky B. A morphological study of cooling rate response in normal and neoplastic human liver tissue: cryosurgical implications. Cryobiology 1993;30:482–92.
Steeves RA. Hyperthermia in cancer therapy: where are we today and where are we going? Bull N Y Acad Med 1992;68:341–50.
Siperstein AE, Rogers SJ, Hansen PD, Gitomirsky A. Laparoscopic thermal ablation of hepatic neuroendocrine tumor metastases. Surgery 1997;122:1147–54.
Goldburg SN, Gazelle GS, Solbiati L. Ablation of liver tumors using percutaneous RF therapy. Am J Res 1998;170:1023–8.
Lencioni R, Goletti O, Armillotta N, et al. Radio-frequency thermal ablation of liver metastases with a cooled-tip electrode needle: results of a pilot clinical trial. Eur Radiol 1998;8:1205–11.
Nagata Y, Hiraoka M, Nishimura Y, et al. Clinical results of radiofrequency hyperthermia for malignant liver tumors. Int J Radiat Oncol Biol Phys 1997;38:359–65.
McGahan JP, Brock JM, Tesluk H, Gu WZ, Schneider P, Browning PD. Hepatic ablation with use of radio-frequency electrocautery in the animal model. J Vasc Interv Radiol 1992;3:291–7.
Curley SA, Izzo F, Delrio P, et al. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 1999;230:1–8.
Curley S, Izzo F, Ellis LM, Woodall M, Wolff R, Vauthey JN. Radiofrequency ablation of malignant liver tumors in 304 patients. Paper presented at: Proceedings ASCO; May 2000; New Orleans, LA.
Tuttle T. Hepatectomy for noncolorectal liver metastases Curley SA Eds. Liver Cancer. New York: Springer-Verlag Publishers, 1998: 201–11.
Curley SA, Davidson BS, Fleming RY, et al. Laparoscopically guided bipolar radiofrequency ablation of areas of porcine liver. Surg Endosc 1997;11:729–33.
Curley SA, Izzo F, Ellis LM, Nicolas Vauthey J, Vallone P. Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 2000;232:381–91.
Patterson J, Strang R. The role of blood flow in hyperthermia. Int J Radiat Oncol Biol Phys 1979;5:235–41.
Kolios MC, Sherar MD, Hunt JW. Large blood vessel cooling in heated tissues: a numerical study. Phys Med Biol 1995;40:477–94.
Sturesson C, Liu DL, Stenram U, Andersson-Engels S. Hepatic inflow occlusion increases the efficacy of interstitial laser-induced thermotherapy in rat. J Surg Res 1997;71:67–72.
Curley SA. Radiofrequency ablation of malignant liver tumors. Oncologist 2001;6:14–23.
Solbiati L, Ierace T, Tonolini M, Osti V, Cova L. Radiofrequency thermal ablation of hepatic metastases. Eur J Ultrasound 2001;13:149–58.
Siperstein A, Garland A, Engle K, et al. Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors. Ann Surg Oncol 2000;7:106–13.
Wood TF, Rose DM, Chung M, Allegra DP, Foshag LJ, Bilchik AJ. Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications. Ann Surg Oncol 2000;7:593–600.
Bowles BJ, Machi J, Limm WM, et al. Safety and efficacy of radiofrequency thermal ablation in advanced liver tumors. Arch Surg 2001;136:864–9.
de Baere T, Elias D, Dromain C, et al. Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. AJR Am J Roentgenol 2000;175:1619–25.
Siperstein AE, Berber E. Cryoablation, percutaneous alcohol injection, and radiofrequency ablation for treatment of neuroendocrine liver metastases. World J Surg 2001;25:693–6.
Wessels FJ, Schell SR. Radiofrequency ablation treatment of refractory carcinoid hepatic metastases. J Surg Res 2001;95:8–12.
Choi H, Loyer EM, Dubrow RA, et al. Radiofrequency ablation (RFA) of liver tumors: assessment of therapeutic response and complications. Radiographics 2001;21:S41–S54.
Catalano O, Lobianco R, Esposito M, Siani A. Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns. Abdom Imaging 2001;26:375–83.
Cioni D, Lencioni R, Bartolozzi C. Percutaneous ablation of liver malignancies: imaging evaluation of treatment response. Eur J Ultrasound 2001;13:73–93.
Cedrone A, Pompili M, Sallustio G, Lorenzelli GP, Gasbarrini G, Rapaccini GL. Comparison between color power Doppler ultrasound with echo-enhancer and spiral computed tomography in the evaluation of hepatocellular carcinoma vascularization before and after ablation procedures. Am J Gastroenterol 2001;96:1854–9.
Ravikumar TS, Jones M, Serrano M, Kaleya R, Valdivia A, Mil-stein DM. The role of PET scanning in radiofrequency ablation of liver metastasis from colorectal cancer. Cancer Journal 2000; 6(Suppl 4):S330–S43.
Donckier V, Luc Van Laethem J, Feron P, et all., Contribution of FDG positron emission tomography in the evaluation of the treatment of liver metastasis using radiofrequency ablation. (in press).
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Curley, S.A. Radiofrequency Ablation of Malignant Liver Tumors. Ann Surg Oncol 10, 338–347 (2003). https://doi.org/10.1245/ASO.2003.07.017
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DOI: https://doi.org/10.1245/ASO.2003.07.017