Skip to main content
Log in

Laparoscopic radiofrequency ablation of unresectable hepatic malignancies

A phase 2 trial

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Radiofrequency ablation (RFA) of hepatic malignancies has been performed successfully via a percutaneous route or at laparotomy. We analyzed the efficacy and utility of laparoscopic intraoperative ultrasound and RFA in patients with unresectable hepatic malignancies.

Methods

Between November 1997 and November 1999, 27 patients with unresectable hepatic malignancies and no evidence of extrahepatic disease were entered in a phase 2 trial of laparoscopic intraoperative ultrasound and RFA. Real-time ultrasonography was used to guide RFA, and lesions were ablated at a temperature of 100°C for 10 min. Overlapping ablations were performed for larger lesions.

Results

Additional tumors were identified in 10(37%) of the 27 study patients by laparoscopy and laparoscopic intraoperative ultrasound despite extensive preoperative imaging. Radiofrequency ablation of 85 hepatic tumors yielded no mortality and only one case of postoperative bleeding. During a mean follow-up period of 14 months, four tumors (4.7%) locally recurred. Of the 27 patients, 11 (41%) remain free of disease at this writing; (22%) are alive with disease: and 10 (37%) have died with disease.

Conclusion

Laparoscopic RFA and introperative ultrasound constitute a safe and accurate method for ablation of unresectable hepatic tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bilchik A, Rose D, Allegra D, Bostick P, Hsueh E, Morton D (1999) Radiofrequency ablation: a minimally invasive technique with multiple applications. Cancer J Sci Am 5: 356–361

    PubMed  CAS  Google Scholar 

  2. Cady B, Jenkins R, Steele G, Lewis D, Stone M, McDermott W, Jessup J, Bothe A, Lalor P, Lovett E, Lavin P, Linehan D (1998) Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome. Ann Surg 227: 566–571

    Article  PubMed  CAS  Google Scholar 

  3. Clarke M, Kane R, Steele G, Hamilton E, Ravikumar T, Onik G, Clouse M (1989) Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors. Surgery 106: 849–855

    PubMed  CAS  Google Scholar 

  4. Curley S, Izzo F, Delrio P, Ellis L, Granchi J, Vallone P, Fiore F, Pignata S, Daniele B, Cremona F (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies. Ann Surg 230: 1–8

    Article  PubMed  CAS  Google Scholar 

  5. Cushing H, Bovie W (1928) Electrosurgery as an aid to the removal of intracranial tumors. Surg Gynecol Obstet 47: 751–784

    Google Scholar 

  6. Elias D, Debaere T, Muttillo I, Cavalcanti A, Coyle C, Roche A (1998) Intraoperative use of radiofrequency treatment allows an increase in the rate of curative liver resection. J Surg Oncol 67: 190–191

    Article  PubMed  CAS  Google Scholar 

  7. Hamazoe R, Maeta M, Murakami A, Yamashiro H, Kaibara N (1991) Heating efficiency of radiofrequency capacitative hyperthermia for treatment of deep-seated tumors in the peritoneal cavity. J Surg Oncol 48: 176–179

    Article  PubMed  CAS  Google Scholar 

  8. John T, Greig J, Crosbie J, Miles A, Garden O (1994) Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound. Ann Surg 220: 711–719

    Article  PubMed  CAS  Google Scholar 

  9. Kohne CH, Lorenz M, Herrmann R (1998) Colorectal cancer liver metastasis: local treatment for a systemic disease? Ann Oncol 9: 967–971

    Article  PubMed  CAS  Google Scholar 

  10. McGahan J, Browning P, Brock J, Tesluk H (1990) Hepatic ablation using radiofrequency electrocautery. Invest Radiol 25: 267–270

    Article  PubMed  CAS  Google Scholar 

  11. McGahan J, Schneider P, Brock J, Tesluk H (1993) Treatment of liver tumors by percutaneous radiofrequency electrocautery. Semin Intervent Radiol 10: 143–149

    Article  Google Scholar 

  12. McMurrick P, Nelson H (1997) Liver-directed therapies for gastroin-testinal malignancies. Current Opin Oncol 9: 367–372

    Article  CAS  Google Scholar 

  13. Patterson E, Scudamore C, Owen D, Nagy A, Buczkowski A (1998) Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size. Ann Surg 227: 559–565

    Article  PubMed  CAS  Google Scholar 

  14. Rahusen F, Cuesta M, Borgstein P, Bleichrodt R, Barkhof F, Doesburg T, Meijer S (1999) Setection of patients for resection of colorectal metastases to the liver using diagnostic laparoscopy and laparoscopic ultrasonography. Ann Surg 230: 31–37

    Article  PubMed  CAS  Google Scholar 

  15. Rossi S, Di Stasi M, Buscarini E, Cavanna L, Quaretti P, Squassante E, Garbagnati F, Buscarini L (1995) Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma. Cancer J Sci Am 1: 73–81

    PubMed  CAS  Google Scholar 

  16. Rossi S, Di Stasi M, Buscarini E, Quaretti P, Garbagnati F, Squassante L, Paties C, Silverman D, Buscarini L (1996) Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR Am J Roentgenol 167: 759–768

    PubMed  CAS  Google Scholar 

  17. Sarantou T, Bilchik A, Ramming K (1998) Complications of hepatic cryosurgery. Semin Surg Oncol 14: 156–162

    Article  PubMed  CAS  Google Scholar 

  18. Siperstein A, Rogers S, Hansen P, Gitomirsky A (1997) Laparoscopic thermal ablation of hepatic neuroendocrine metastases. Surgery 122: 1147–1155

    Article  PubMed  CAS  Google Scholar 

  19. Sironi S, Livraghi T, DelMaschio A (1991) Small hepatocellular carcinoma treated with percutaneous ethanol injection: MR imaging findings. Radiology 180: 333–336

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Online publication: 12 June 2001

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chung, M.H., Wood, T.F., Tsioulias, G.J. et al. Laparoscopic radiofrequency ablation of unresectable hepatic malignancies. Surg Endosc 15, 1020–1026 (2001). https://doi.org/10.1007/s00464-001-0026-2

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-001-0026-2

Key words

Navigation