Radio-Frequency Ablation (RFA) of Liver Tumors
Overview
Radiofrequency ablation (RFA) is an exciting new
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| RFA Generator |
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| RFA Electrode Tip |
approach to destroying inoperable primary or metastatic tumors in the liver. A probe is inserted through the liver tissue with ultrasound guidance into the tumor and delivers alternating current (radiofrequency energy). Heat is generated at the site of the lesion and produces destruction (necrosis) of the tumor with near pinpoint accuracy. The tumor is literally "burned out" by the heat. This technology has been used in thousands of patients in the United States and Europe. The RFA program at UPMC was started in 1999, and more than 300 patients have received this form of therapy at the Liver Cancer Center with very good results.
The Procedure
A major attraction is that the RFA procedure can often be done by "minimally invasive" surgery. The approaches include one of
the following:
- percutaneous (through the skin without an operation
- laparoscopic (several small incisions)
- open RFA through an abdominal incision.
In some cases, superficial tumors can be wedged out (excised), while deeper lesions can be destroyed by RFA, thereby preserving most of the liver tissue. The decision regarding which approach is best for each patient is made based on the number and location of the tumors in the liver. In most cases, only a single treatment is necessary for any given tumor. Although the maximum tumor size that can be treated by RFA has yet to be determined with certainty, the technique appears to be best for tumors less than 5 centimeters in size.
The procedure lasts between 20 minutes and two hours depending on the size and number of tumors. RFA is generally well-tolerated with minimal to no pain after the treatment. Some patients will experience a low-grade fever for a few days after the procedure. There is a very low risk of bleeding or infection after the treatment. Patients usually go home the next morning for percutaneous and laparoscopic approaches. Patients requiring open RFA surgery usually stay two to four days in the hospital. Follow-up CT scans are obtained every few months to watch for tumor recurrences.
Example of actual RFA cases at UPMC Liver Cancer Center
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| 3 “keyhole” incisions for Laparoscopic RFA |
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| Pre-op CT scan: Tumor |
three-months post RFA:
Post-ablation changes |