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The safety of radiofrequency thermal ablation in the treatment of liver malignancies

The safety of radiofrequency thermal ablation in the treatment of liver malignancies
The safety of radiofrequency thermal ablation in the treatment of liver malignancies
Introduction: Radiofrequency ablation (RFA) has become widely accepted as an important adjunct, and sometimes a viable alternative, to liver surgery. The aims of this study are to assess the risks associated with percutaneous RFA and to discuss the indications and contraindications to its use.

Patients and methods: This is a review of 130 consecutive patients who were treated for primary (n = 92) and metastatic (n = 38) liver tumours. Only complications after percutaneous RFA (83 patients) were evaluated. Interesting case studies are included to highlight potential complications following RFA and their management.

Results: One patient died of perforation of the colon and five others had major complications. There were 15 minor complications. Local recurrence rates reached 30% overall, and a further 25 patients developed a new hepatic lesion, different from the one treated by RFA. Median disease-free survival was 13 months. Overall survival rates at 1, 2 and 5 years were 85.3%, 71.3% and 57.6%, respectively.

Conclusion: Percutaneous RFA is a safe and efficient technique but not free of complications and with potential fatal outcome. It is also associated with significant local recurrence rates. The procedure should only be performed following adequate training and the indication should always be discussed in multidisciplinary meetings. Patient's liver function and general health as well as tumour size and position must be considered. Intraoperative or video laparoscopic RFA is useful for superficial tumours in order to avoid damage to viscera surrounding the liver surface.
percutaneous radiofrequency thermal ablation, hepatocellular carcinoma, liver metastases, complications of rfa
0748-7983
668-672
Casaril, A.
5da630e8-9302-45b0-b768-c76d2c007037
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Harb, A.
e5efdb5c-cb37-4cae-b444-5769e1c9cc12
Campagnaro, T.
18360edb-a219-4164-9255-05e08101cc54
Mansueto, G.
c1dfd211-28e0-41fc-8950-86ff19ac9335
Nicoli, N.
6f8980e7-f566-490d-b9dc-a1337e632400
Casaril, A.
5da630e8-9302-45b0-b768-c76d2c007037
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Harb, A.
e5efdb5c-cb37-4cae-b444-5769e1c9cc12
Campagnaro, T.
18360edb-a219-4164-9255-05e08101cc54
Mansueto, G.
c1dfd211-28e0-41fc-8950-86ff19ac9335
Nicoli, N.
6f8980e7-f566-490d-b9dc-a1337e632400

Casaril, A., Abu Hilal, M., Harb, A., Campagnaro, T., Mansueto, G. and Nicoli, N. (2008) The safety of radiofrequency thermal ablation in the treatment of liver malignancies. European Journal of Surgical Oncology, 34 (6), 668-672. (doi:10.1016/j.ejso.2007.05.003). (PMID:17681717)

Record type: Article

Abstract

Introduction: Radiofrequency ablation (RFA) has become widely accepted as an important adjunct, and sometimes a viable alternative, to liver surgery. The aims of this study are to assess the risks associated with percutaneous RFA and to discuss the indications and contraindications to its use.

Patients and methods: This is a review of 130 consecutive patients who were treated for primary (n = 92) and metastatic (n = 38) liver tumours. Only complications after percutaneous RFA (83 patients) were evaluated. Interesting case studies are included to highlight potential complications following RFA and their management.

Results: One patient died of perforation of the colon and five others had major complications. There were 15 minor complications. Local recurrence rates reached 30% overall, and a further 25 patients developed a new hepatic lesion, different from the one treated by RFA. Median disease-free survival was 13 months. Overall survival rates at 1, 2 and 5 years were 85.3%, 71.3% and 57.6%, respectively.

Conclusion: Percutaneous RFA is a safe and efficient technique but not free of complications and with potential fatal outcome. It is also associated with significant local recurrence rates. The procedure should only be performed following adequate training and the indication should always be discussed in multidisciplinary meetings. Patient's liver function and general health as well as tumour size and position must be considered. Intraoperative or video laparoscopic RFA is useful for superficial tumours in order to avoid damage to viscera surrounding the liver surface.

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More information

Published date: June 2008
Keywords: percutaneous radiofrequency thermal ablation, hepatocellular carcinoma, liver metastases, complications of rfa

Identifiers

Local EPrints ID: 172541
URI: http://eprints.soton.ac.uk/id/eprint/172541
ISSN: 0748-7983
PURE UUID: 68ad4ad7-5f16-4ecc-b648-fda3ce0251d0

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Date deposited: 27 Jan 2011 09:40
Last modified: 14 Mar 2024 02:29

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Contributors

Author: A. Casaril
Author: M. Abu Hilal
Author: A. Harb
Author: T. Campagnaro
Author: G. Mansueto
Author: N. Nicoli

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