SY4-6 - Radiofrequency Ablation (Rfa) for Liver Tumors

Abstract

In RFA, heat generated around the electrode tip coagulates tumor tissue. Sophisticated RFA, which can ablate the entire tumor, is curative, minimally-invasive, easy to treat recurrence, and cost-effective. RFA has been widely performed for hepatocellular carcinoma (HCC), because only 20-30 % of patients are candidates for resection. Furthermore, recurrence develops in 70-80% of patients within 5 years after hepatectomy. In our over 10-year experience of RFA, we performed 2,982 RFA treatments on 1,170 primary HCC patients. Final CT images showed complete tumor ablation in 2,964(99.4 %)of the 2,982 treatments. In the 1,170 patients, with a median follow-up of 38.2 months, 5- and 10-year survival rates were 60.2 % and 27.3 %, respectively. RFA also plays an important role in the treatment of metastatic liver tumors. For example, only 10-30 % of patients with colorectal liver metastasis(CRLM)are candidates for resection. Furthermore, recurrence-free survival after hepatectomy is around 20% at 5 years. We evaluated 192 consecutive patients with CRLM treated by RFA. The 1-, 3-, 5-, and 10-year survival rates were 94%, 64%, 38%, and 26%, respectively. The number of 5-, and 10-year survivors was 29, and 4, respectively. There is a woman, who underwent Miles' operation in 1997, hepatic resection in 1998, and RFA in 2000. She has survived for more than 14 years after RFA and is 97 years old now. Outcomes in over 10-year period clearly show that RFA is a curative treatment and enables long-term survival not only in HCC but also in metastatic liver tumors. A strategy to find recurrence at an early stage and repeat the minimally invasive treatment is useful. Refined RFA may be a first-line treatment for selected patients with HCC or metastatic liver tumors. In addition, various innovative techniques such as contrast enhanced ultrasound and multimodality fusion imaging will further improve outcomes of RFA.