Radiofrequency Ablation for Liver Cancer

Radiofrequency ablation (RFA) is another important surgical tool for the treatment of patients with liver cancer, according to an article in a recent issue of The Oncologist (2001;6:1). The journal features papers by several doctors on this application of RFA.

Primary liver cancer is one of the most common cancers in the world, especially in Asia and Africa. The liver is also the second most common site of metastases from other solid tumors, most often from colorectal cancer. In an opening commentary, Prof. H. M. Pinedo and Dr. C.J. van Groeningen of the Free University Hospital (Amsterdam, The Netherlands) explain that decades ago, a diagnosis of primary or metastatic liver cancer was a death warrant, so therapeutics were not a consideration. Since then, chemotherapy has not succeeded in treating liver cancer and has shown only limited success in treating metastatic liver cancer. Although the gold standard of care has become surgical removal, Dr. Pinedo says that RFA is a good tool to be added in any multidisciplinary approach.

In two accompanying papers, Dr. Steven A. Curley (M.D. Anderson Cancer Center, Houston, TX, USA) and Dr. Anton J. Bilchik (John Wayne Cancer Institute, Santa Monica, CA, USA) discuss their experiences with RFA. In general, Dr. Curley found it a safe, well-tolerated treatment that was effective for unresectable tumors less than 6.0 cm in diameter. While it is not likely to cure most patients, some may experience long-term disease-free survival. Dr. Bilchik and colleagues recommend the use of RFA only for tumors 5.0 cm or smaller. They conclude that although severe complications or death are rare following RFA, patients and RFA approaches should be carefully selected.