Radiofrequency for the Treatment of Liver Tumours

Abstract

Resection should still be considered the gold standard for many liver tumours. There is, however, growing interest in the use of radiofrequency (RFA) for the treatment of liver tumours. By RFA, tumour tissue can be destructed selectively without significant damage to vascular structures in the remaining liver. The technique is safe and feasible for many types of liver tumours. RFA appears to be beneficial in the treatment of hepatocellular carcinoma. In the Netherlands, single-centre reports suggest that RFA may be used successfully to control hepatocellular carcinoma in those patients awaiting liver transplantation. RFA is being increasingly used for colorectal liver metastases as an adjunct to surgical resection in case of unresectable lesions. However, to date, there are still no data showing that such an approach is beneficial. For this reason, in the Netherlands, RFA for unresectable colorectal liver metastases is mainly used within a clinical trial. Within the multimodality treatment of neuroendocrine metastases, RFA may deserve a place for either intention to cure (rare) or debulking with the aim of reduction of symptoms or prolongation of life.

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

“…It is hoped that the current analysis and proposal strengthens the opinion of the proponents [19, 25, 30, 31, 36, 37, 42, 46, 48, 50, 53, 57, 61, 67, 86, 98, 125, 181,183,184,185,186,187, 192, 193] of such a study and contributes to convince its opponents [18, 58, 59, 62,188,189,190, 194]. We hope that, in the era of evidence-based medicine, the surgical community will support a renewed effort to run such a trial (for more information, please contact: t.ruers@nki.nl or stefaan.mulier@skynet.be).…”

An experimental study of the treatment of liver injury with InLine RFA

“…RFA is one of the methods used in the multimodal treatment of liver tumours 17 ; the InLine bipolar RFA probe was designed to rapidly pre‐coagulate the liver parenchyma of a liver resection plane. It has achieved significant reductions in blood loss in animal models and liver resection in patients in normal, post chemotherapy, steatosis and cirrhotic livers 5–7.…”

Review article: multimodality treatment of liver metastases increases suitability for surgical treatment

“…Furthermore, it offers opportunities in patients who are unfit for a partial liver resection, or in whom a partial liver resection has already been performed and recurrent disease has developed in the remnant liver. Recent reviews summarize the results of RFA for liver tumours 11, 12 …”