Ablative therapies in primary and metastatic liver tumours: An early experience

Abstract

Background: Hepatic resection and hepatic transplantation are considered the only definitive treatment modalities capable of achieving cure for primary and metastatic liver tumours. As few patients qualify to receive these treatments, local ablative therapies are increasingly being used as treatment for primary and metastatic tumours of the liver. Methods: During the period January 2018 to January 2022 we prospectively studied the utility of chemical and thermal ablation ablative therapy in 22 patients with primary and metastatic liver disease. All patients were followed at 1, 3 and 6 months. Results: Percutaneous ethanol injection (PEI) was done in 2 patients. Radiofrequency ablation (RFA) was done in 13 patients [hepatocellular carcinoma (HCC) 8, metastases 5]. With RFA, out of eight HCC patients, complete ablation was seen in 4; 2 patients underwent partial hepatectomy; 2 patients died within a month of ablation due to associated co-morbidities. In 5 patients with metastases, 3 achieved complete ablation; partial hepatectomy and systemic chemotherapy was needed in 1 patient each. With microwave ablation (MA) (n=6; HCC 3, metastases 3), complete ablation was achieved in 3 HCC patients. In patients with metastases, complete ablation was seen in 2 and one patient in addition, underwent transarterial chemoembolization. One patient with metastasis underwent both RFA and MA; complete ablation was achieved; MA was repeated a few months after RFA as new lesion developed. Conclusions: Our study results suggest that chemical and thermal ablation ablative therapies are effective both as palliative and curative in the management of primary and metastatic liver lesions.