Radiofrequency Ablation

Patient Selection Criteria

Radiofrequency ablation (RFA) is used on patients with inoperable primary or metastatic liver lesions. Generally the lesions must be limited to the liver, although RFA may be used for relief of symptoms in patients with disease outside the liver. The ideal patient for RFA generally will have no more than three lesions that are no greater than 4 cm (about 1 ½ inch) in size. Based on review of the CT scan, the doctor will decide if it RFA is the appropriate treatment.

Description of Procedure

Radiofrequency (RF) is electrical energy that is used to create heat in a specific location, for a specific period of time. The result is destruction or death of liver lesions. RF has been used in medical procedures for decades. The procedure can be performed percutaneously (inserting the probe through a large needle through the skin), or laparoscopically (using a scope inserted through a small incision), or in an open surgical procedure. Using ultrasound or CT to guide the instruments, the RFA probe is placed directly into the lesion. The lesion is heated to temperatures above 113 degrees F, causing lesion destruction without sacrificing normal surrounding tissue.

Risks/Side Effects/Complications

RFA is a safe, well-tolerated, and effective procedure to achieve lesion destruction in patients with inoperable liver lesions. There are a few reported complications. Many patients will experience low-grade fevers for a few days following the procedure. There is a very low risk of infection (abcess), bleeding, collapse of the lung, abnormal heart rhythms, and skin burn.

Recovery Time and Lifestyle Changes

Depending on the method used, recovery time will differ. If the percutaneous method is used, the patient is often able to go home that same day. With laparoscopic RFA, patients generally go home the next day. In an open approach an incision is made, general anesthesia is needed and the recovery period is a bit longer.

Sometimes RFA is combined with other therapies, such as chemotherapy. The choice of continued therapy after RFA depends on several conditions, and should be discussed with the doctor.

Effectiveness

According to an article published in the Annals of Surgery, a post-procedure study of 181 ablated lesions revealed only 22 lesions with signs of recurrence within the first six months(or a 12% local failure rate). No procedural related deaths occurred and there were no observed complications requiring treatment. All of the ablated lesions were completely necrotic (dead) on imaging studies immediately after completion of RFA procedures, concluding that RFA is a safe, well-tolerated and effective procedure to achieve lesion destruction in patients with inoperable liver lesions.

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