Radiofrequency Ablation May Hold Promise for Treatment of Small Liver Cancers

Radiofrequency Ablation May Hold Promise for Treatment of Small Liver Cancers

Cancer of the liver can sometimes removed by surgery, but this type of treatment is not always an option for persons with very large cancerous tumors or with many cancerous tumors in the liver. Now, a technique called radiofrequency ablation is offering hope for a new way to treat persons with liver cancers: the administration of radiofrequency energy directly into the liver cancer cells, through the skin or by surgery, to destroy the tumor.

The

liver is the largest organ in the human body. It is also a necessary organ to sustain life; therefore, treatment to remove the entire liver cannot be done as it can with many other vital organs. Cancer can develop and grow in the liver (called

primary liver cancer) or can spread to the liver from other areas, such as the colon and rectum. When possible, the cancer is surgically removed from the liver. However, many cancers of the liver are too large or are present in too many places on the liver to be removed by surgery. For persons with this type of liver cancer, treatments such as chemotherapy, radiation therapy, and other types of surgery may be used to control the cancer, relieve the symptoms of disease, and prolong survival time. Researchers continue to develop and study therapies that are more effective and/or cause fewer side effects for persons with this disease. One innovative new treatment strategy that is currently being investigated is called radiofrequency ablation, a type of therapy with potentially less severe side effects than those often experienced with chemotherapy.

Radiofrequency ablation entails the use of high-energy radio waves that can be administered through the skin using a probe, about the size of a needle, into the tumor(s) in the liver. The doctor uses an imaging scan, such as an ultrasound or a computerized tomography (CT) scan, to guide the probe to the right spot(s) in the liver. The high-energy radio waves heat the cancer cells such that they later become coagulated and are destroyed. The radio waves can also be delivered into the tumor as part of a surgical procedure. Researchers in Massachusetts recently conducted a study to determine whether these radiofrequency ablation techniques are safe and whether they indeed cause damage to or destroy cancer cells in the liver.

Researchers at the Massachusetts General Hospital treated 22 patients, who had a total of 23 liver cancer tumors, with radiofrequency ablation. The high-energy radio waves were delivered through the skin in 12 cancers and through surgery in 11 cancers, all with the guidance of an ultrasound or CT scan. The tumors were surgically removed 3 to 7 days later and examined for evidence of being damaged or destroyed by the radio waves. The researchers found that the radio waves had indeed resulted in coagulation and irreversible damage of the cancer cells, but also that this effect took place over a period of time.

These researchers concluded that radiofrequency ablation is a safe and minimally invasive strategy and appears to have potential for the treatment of liver cancer. They noted however that it may only be useful in smaller liver cancers and that further study is needed to demonstrate the complete destruction of the cancer cells with this technique. Persons who have cancer in the liver may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which radiofrequency ablation or another promising new treatment strategy is being studied.

(Cancer, Vol 88, No 11, pp 2452-2463, 2000)

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