Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 3724
© 2004 American Society of Clinical Oncology

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Abstract

The local ablation with radiofrequency enables a safe and efficient treatment of small liver tumors

Chirurgie - Kantonsspital, Liestal, Switzerland; Kantonsspital, Liestal, Switzerland

3724

Background: Numerous publications during the last 3 years have reported on the successful treatment of liver tumors by means of radiofrequency with lower morbidity and mortality rate compared to surgery. This article reports our personal experience since 1998 with the RITA–radiofrequency ablation-system. Methods: Local ablation are performed in patients with impossibility of R0-resection or poor general condition (64.2%) and where liver metastasectomy is not indicated (18.3%). A radiofrequency electrode is placed under ultrasound control. This generate a local temperature of 80 to 120°C. The coagulation arises from heat transfer and is constantly monitored by means of 5 periferal temperature probes. Postoperative checks were carried out by means of 3-phases contrast enhanced CT within 1 week and then after 3,6,12,18 and 24 months. Results: Since 1.4.1998 80 patients with 248 liver tumors were treated during 109 ablation sessions. The median postoperative observation period of patients with a follow up more than 6 months (71.2% of all patients) was 21 months. A complete ablation could be documented in 97.1% (239/246). The local recurrence rate was 8.7% (21/239). For tumors of less than 3 cm a local recurrence rate of 5.2% (4/76) has been documented with the older needles, compared to 0.98% (1/102) since the introduction of new ones. 4 patients developed a liver abscess, 2 of them were after a bilio-digestiv anastomosis, 1 patient with a complicated infection of a venous port system. In one after right hemihepatectomy and ablation of a central located metastasis a bile duct stenosis occurred. Conclusions: The radiofrequency ablation is a new possibility in the effective and uncomplicated treatment of liver tumors. The very low rate of local recurrence in tumors of less than 3cm (0.98%) raises the question of whether tumors of such size can in future be treated by means of local radiofrequency ablation. At present the radiofrequency ablation is indicated in case of non resectable liver tumors or where a liver resection is not indicated. Caution is necessary in the case of patients with biliodigestiv anastamosis and in any cases with potentially infectious situations.

Author Disclosure

Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration RITA