Liver Cancer Treatment & Ongoing Care

Radiofrequency Ablation as Liver Cancer Treatment

Radiofrequency ablation, hereafter called RFA, is a technique of heating up liver cancers with probes inserted into the cancers. The probe is hooked to a machine which drives current in a high frequency alternating—back and forth--path which results in heating the liver tissue to the level of 90 to 100 degrees Centigrade (100 degrees C=212 degrees Fahrenheit). This temperature cooks the tissues around it. A straight needle like probe will cook the tissues around it in a limited elliptical fashion which will not kill or “ablate” all of the cancer it is put in, except for the very smallest cancers. However, two advances have made RFA a worthwhile endeavor. First, the ability to localize quite well tumors of sizes down to a centimeter by intraoperative ultrasound allows pinpoint accuracy in finding where the tumors are. Second, new technologies which allow the tumors to be cooked slowly and over a broader field allow bigger tumor masses to be killed. The engineering of multiple tines on these probes allows the ablation of lesions up to 6 to 7 centimeters. This greatly expands the clinical application of this technology in a much wider range of patients needing liver cancer treatment .

Advances with Radiofrequency Ablation

RFA has, at present, three companies who have commercialized this technology. The probe which I presently use is by RITA Technologies. RITA stands for Radiofrequency Interstitial Therapeutic Ablation. It has the largest potential for single insertion ablation of masses at seven centimeters. The success rate in killing these tumors, however, drops off as the tumor size increases. These technologies are still evolving and I expect further advances in the next few years in this ablative technology. However, RFA is totally dependent on the ability to see these tumors with ultrasound. The sonographic interpretation of sound waves passed through the body’s tissues is not on a par with CT or MRI when the sound waves are passed through the body wall. However, when the body wall is taken out of the equation, as is the case with laparoscopic or open operation, ultrasound is superior, without question, to other techniques. This allows the discovery of tumors which would not have been found as well as the best available technique for monitoring the success of the ablation. I believe that many liver cancer treatment patients can be helped with RFA alone or in combination with liver resection.

Methods of Radiofrequency Ablation

Although RFA can be done percutaneously (through the skin), sonography through the abdominal wall is much less sensitive than at time of surgery. Therefore the failure rate with percuataneous RFA is significantly higher than when done by laparoscopy or at open operation. I do RFA either at laparoscopy through a few bandaid type incisions or through an open operation. If the lesion can be safely approached with good expectation of control of the cancer, then I will do it laparoscopically. If the lesion is deep or posterior within the liver or if there are multiple tumors, then I am more likely to open the abdomen with an incision beneath the ribs. The patient who is able to have laparoscopic surgery can go home the next morning. The patient with an open operation remains in the hospital for at least three days. The important thing, however, is not length of hospital stay. It is getting rid of the cancer.

Learn how resection and ablation are used together as a method of liver cancer treatment.

Contact my office to find out more about the use of Radiofrequency Ablation as a method of liver cancer treatment.