OBJECTIVE: To describe the safety and efficacy of radiofrequency ablation (RFA) to treat unresectable malignant hepatic tumors in 123 patients. BACKGROUND: The majority of patients with primary or metastatic malignancies confined to the liver are not candidates for resection because of tumor size, location, or multifocality or inadequate functional hepatic reserve. Local application of heat is tumoricidal; therefore, the authors investigated a novel RFA system to treat patients with unresectable hepatic cancer. PATIENTS AND METHODS: Patients with hepatic malignancies were entered into a prospective, nonrandomized trial. The liver tumors were treated percutaneously or during surgery under ultrasound guidance using a novel LeVeen monopolar array needle electrode and an RF 2000 generator. All patients were followed to assess complications, treatment response, and recurrence of malignant disease. RESULTS: RFA was used to treat 169 tumors (median diameter 3.4 cm, range 0.5 to 12 cm) in 123 patients. Primary liver cancer was treated in 48 patients (39.1%), and metastatic liver tumors were treated in 75 patients (60.9%). Percutaneous and intraoperative RFA was performed in 31 patients (35.2%) and 92 patients (74.8%), respectively. There were no treatment-related deaths, and the complication rate after RFA was 2.4%. All treated tumors were completely necrotic on imaging studies after completion of RFA treatments. With a median follow-up of 15 months, tumor has recurred in 3 of 169 treated lesions (1.8%), but metastatic disease has developed at other sites in 34 patients (27.6%). CONCLUSIONS: RFA is a safe, well-tolerated, and effective treatment to achieve tumor destruction in patients with unresectable hepatic malignancies. Because patients are at risk for the development of new metastatic disease after RFA, multimodality treatment approaches that include RFA should be investigated.
OBJECTIVE: To describe the safety and efficacy of radiofrequency ablation (RFA) to treat unresectable malignant hepatic tumors in 123 patients. BACKGROUND: The majority of patients with primary or metastatic malignancies confined to the liver are not candidates for resection because of tumor size, location, or multifocality or inadequate functional hepatic reserve. Local application of heat is tumoricidal; therefore, the authors investigated a novel RFA system to treat patients with unresectable hepatic cancer. PATIENTS AND METHODS: Patients with hepatic malignancies were entered into a prospective, nonrandomized trial. The liver tumors were treated percutaneously or during surgery under ultrasound guidance using a novel LeVeen monopolar array needle electrode and an RF 2000 generator. All patients were followed to assess complications, treatment response, and recurrence of malignant disease. RESULTS: RFA was used to treat 169 tumors (median diameter 3.4 cm, range 0.5 to 12 cm) in 123 patients. Primary liver cancer was treated in 48 patients (39.1%), and metastatic liver tumors were treated in 75 patients (60.9%). Percutaneous and intraoperative RFA was performed in 31 patients (35.2%) and 92 patients (74.8%), respectively. There were no treatment-related deaths, and the complication rate after RFA was 2.4%. All treated tumors were completely necrotic on imaging studies after completion of RFA treatments. With a median follow-up of 15 months, tumor has recurred in 3 of 169 treated lesions (1.8%), but metastatic disease has developed at other sites in 34 patients (27.6%). CONCLUSIONS: RFA is a safe, well-tolerated, and effective treatment to achieve tumor destruction in patients with unresectable hepatic malignancies. Because patients are at risk for the development of new metastatic disease after RFA, multimodality treatment approaches that include RFA should be investigated.
Authors: Y Fong; A M Cohen; J G Fortner; W E Enker; A D Turnbull; D G Coit; A M Marrero; M Prasad; L H Blumgart; M F Brennan Journal: J Clin Oncol Date: 1997-03 Impact factor: 44.544
Authors: T Livraghi; S N Goldberg; F Monti; A Bizzini; S Lazzaroni; F Meloni; S Pellicanò; L Solbiati; G S Gazelle Journal: Radiology Date: 1997-01 Impact factor: 11.105
Authors: L Solbiati; T Ierace; S N Goldberg; S Sironi; T Livraghi; R Fiocca; G Servadio; G Rizzatto; P R Mueller; A Del Maschio; G S Gazelle Journal: Radiology Date: 1997-01 Impact factor: 11.105
Authors: S Rossi; M Di Stasi; E Buscarini; P Quaretti; F Garbagnati; L Squassante; C T Paties; D E Silverman; L Buscarini Journal: AJR Am J Roentgenol Date: 1996-09 Impact factor: 3.959
Authors: D J Scott; W N Young; L M Watumull; G Lindberg; J B Fleming; J F Huth; R V Rege; D R Jeyarajah; D B Jones Journal: Surg Endosc Date: 2001-02 Impact factor: 4.584
Authors: M D Scott DJ; W N Young; L M Watumull; G Lindberg; J B Fleming; R V Rege; R J Brown; D B Jones Journal: J Gastrointest Surg Date: 2000 Nov-Dec Impact factor: 3.452
Authors: Jean-Christophe Weber; Giuseppe Navarra; Long R Jiao; Joanna P Nicholls; Steen Lindkaer Jensen; Nagy A Habib Journal: Ann Surg Date: 2002-11 Impact factor: 12.969
Authors: Bruno Morgan; Andrew S Kennedy; Val Lewington; Bleddyn Jones; Ricky A Sharma Journal: Nat Rev Clin Oncol Date: 2010-10-05 Impact factor: 66.675