Radiofrequency Ablation For Liver Cancer Treatment

Radiofrequency ablation (RFA) is a new technique used to treat benign and malignant liver tumors, often without the long incisions traditionally used in liver tumor ablation. In the past, destruction of liver tumors could only be accomplished by freezing (cryoablation) or injection with toxic chemicals. RFA combines the advantages of improved technology and minimally invasive surgery to give patients another option for treatment of liver tumors.

It is the preferred treatment when diseased tissue is small or cannot be surgically removed. It can be most frequently performed by our radiologists under ultrasound guidance using a probe passed through the skin and into the liver tumor. Sedation is required during the ablation procedure and patients return home typically the same day. This procedure has a high chance of cure for tumors less than about 1 inch in diameter and can be repeated if necessary.

How Does RFA Work?

Using intraoperative imaging of the tumor with ultrasound, an electrode is positioned strategically within the lesion. Then, the electrode is connected to a unique radiofrequency generator and electrical current is delivered into the tissue. As the cells are heated, they are destroyed. The mechanism of RFA is similar to that of a microwave oven, heating from the inside out. The body eliminates the destroyed tumor cells over a period of time.

Radiofrequency ablation can be performed using many different approaches, but usually requires surgery and general anesthesia to be done safely. In most cases laparoscopic surgery is used, employing small incisions with a camera placed inside the abdomen to guide the ablation procedure.

Typically three or four small incisions are made. Ports are then inserted into these incisions, which enable the surgeon to easily guide the radiofrequency and ultrasound probes into the liver (see illustration on reverse). The location of each incision depends upon the location of the tumor within the liver. In rare situations, the tumor may be too large for the laparoscopic approach, or may be located in an area that is not safe for laparoscopic surgery. In these cases, a traditional open incision will be used.

During surgery, a small ultrasound probe is also placed into the abdomen to accurately locate the tumor and guide the RFA probe into the center of the tumor. Patients typically spend four hours in surgery.