Clinical short-term results of radiofrequency ablation in liver cancers

AIM:To study local therapeutic efficacy,side effects,andcomplications of radiofrequency ablation(RFA),whichis emerging as a new method for the treatment ofpatients with hepatocellular carcinoma(HCC)withcirrhosis or chronic hepatitis and metastatic liver cancer.METHODS:Thirty-six patients with primary andsecondary liver cancers(21 with primaryhepatocellular carcinoma,12 with colorectal cancerliver metastases and 3 with other malignant livermetastases),which were considered not suitable forcurative resection,were include in this study.Theywere treated either with RFA(RITA2000,MountainView,California,USA)percutaneously(n-20)orintraoperatively(n=16).The procedures wereperformed using the ultrasound guidance.The qualityof RFA Were based on monitoring of equipments andsubject feeling of the practitioners.Patients treatedwith RFA was followed according to clinical findings,radiographic images,and tumor markers.RESULTS:Thirty-six patients underwent RFA for 48nodules.RFA was used to treat an average 1.3 lesionsper patient,and the median size of treated lesions was2.5 cm(range,0.5-9 cm).The average hospital staywas 5.6 days overall(2.8 days for percutaneous casesand 7.9 days for open operations).Seven patientsunderwent a second RFA procedure(sequentialablations).Sixteen HCC patients with a high level ofalpha fetoprotein(AFP)and 9 colorectal cancer livermetastases patients with a high level of serumcarcinoembryonic antigen(CEA)have a great reductionbenefited from RFA.Four(11.1%)patients hadcomplications:one skin burn;one postoperativehemorrhage;one cholecystitis and one hepatic abscessassociated with percutaneous ablations of a largelesion.There were 4 deaths:3 patients died from local and system diseases(1 at 7 month,I at 9 month,and 1at 12 month),I patients died from cardiovascular shock,but no RFA-related death.At a median follow-up of 10months(range,1-24 months),6 patients(16.7 %)hadrecurrences at an RFA site,and 20 patients(56.7 %)remained clinically free of disease.CONCLUSION:RF ablation appears to be an effective,safe,and relatively simple procedure for the treatmentof unresectable liver cancers.The rate and severity ofcomplications appear acceptable.However,furtherstudy is necessary to assess combination with othertherapies,long-term recurrence rates and effect onoverall survival.