Percutaneous radiofrequency thermoablation as an alternative to surgery for treatment of liver tumour recurrence after hepatectomy
- 1 June 2002
- journal article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 89 (6), 752-756
- https://doi.org/10.1046/j.1365-2168.2002.02081.x
Abstract
Background Radiofrequency (RF) current, converted into heat through ion agitation and friction, can destroy liver tumours by means of coagulation necrosis. This study assessed whether percutaneous RF ablation is a useful and safe technique for the treatment of liver tumour recurrence after hepatectomy. Methods Forty-seven patients presenting with local recurrence after hepatectomy for malignant tumours (29 with colorectal secondaries) were treated with percutaneous RF ablation instead of repeat hepatectomy. RF thermal ablation was performed under image guidance for 12–15 min. This group represented 63 per cent of 75 patients treated with curative intent for liver recurrence in the same time interval. The other 28 patients underwent repeat hepatectomy. Results The mean(s.d.) number of liver metastases destroyed was 1·4(0·7) (range 1–3) and their diameter was 21(8) (range 9–35) mm. Twenty-six patients presented with liver recurrence at least once but up to three times after the initial RF application. Incomplete local RF treatment was observed in six of 47 patients. Fifteen patients developed extrahepatic recurrence. The mean(s.d.) interval between RF ablation and the last follow-up visit was 14·4(10·1) (range 5·5–40) months. One death and three major complications occurred. Survival rates at 1 and 2 years were 88 and 55 per cent respectively. A retrospective study of the authors' database over two similar consecutive periods showed that RF ablation increased the percentage of curative local treatments for liver recurrence after hepatectomy from 17 to 26 per cent and decreased the proportion of repeat hepatectomies from 100 to to 39 per cent. Conclusion Percutaneous RF treatment increases the number of patients eligible for curative treatment. It should be preferred to repeat hepatectomy when feasible and safe because it is less invasive. Repeat hepatectomy is indicated only when percutaneous RF ablation is contraindicated or fails.Keywords
This publication has 12 references indexed in Scilit:
- Radiofrequency Ablation of Unresectable Primary and Metastatic Hepatic MalignanciesAnnals of Surgery, 1999
- Small Hepatocellular Carcinoma: Treatment with Radio-frequency Ablation versus Ethanol InjectionRadiology, 1999
- Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: laboratory and clinical experience in liver metastases.Radiology, 1998
- Percutaneous treatment of small hepatic tumors by an expandable RF needle electrode.American Journal of Roentgenology, 1998
- Repeated liver resection for recurrent liver cancerBritish Journal of Surgery, 1996
- Current perspectives on repeat hepatic resection for colorectal carcinoma: A reviewSurgery, 1996
- Tissue ablation with radiofrequency: Effect of probe size, gauge, duration, and temperature on lesion volumeAcademic Radiology, 1995
- Repeat liver resections from colorectal metastasisPublished by Springer Science and Business Media LLC ,1994
- Repeat hepatectomy for cancerBritish Journal of Surgery, 1993
- Patterns of Failure Following Surgical Resection of Colorectal Cancer Liver MetastasesAnnals of Surgery, 1987