Radiofrequency Ablation for Primary and Metastatic Liver Tumors

Abstract

Due to the large number of patients with primary or metastatic hepatic malignancies who are not candidates for surgical resection, novel treatment approaches to control and potentially cure liver tumors have been explored. Percutaneous image-guided ablative therapies using direct intra-tumoral injection of compounds such as ethanol (1-3), hot saline (4), and acetic acid (5), as well as thermally mediated techniques such as cryotherapy (6), microwave therapy (7), interstitial laser photocoagulation (8), and radiofrequency ablation have all recently received much attention as minimally invasive strategies for the treatment of focal malignant diseases. The development of these new minimally invasive techniques has the potential to alter patient outcomes, since existing therapies often have either limited efficacy or are associated with significant morbidity and cost. Potential benefits of ablative therapies compared to surgical resection include the possibility of performing the procedure in the outpatient setting, decreased cost, reduced morbidity and mortality, and the ability to offer treatment to patients who would not be considered candidates for surgery due to age, disease extent, or co-existing morbidity. While the clinical efficacy of some ablative therapies has been established (ethanol injection) (1), the experience with other ablative therapeutic modalities is considerably more preliminary and requires additional assessment. One such ablative technique is radiofrequency tissue ablation.