Email this article 
The radiofrequency ablation as alternative and addition to surgical treatment at liver tumors
- Authors: 1, 1
-
Affiliations:
- Клиника общей и висцеральной хирургии, г. Франкфурт-на-Одере Клиника общей, висцеральной и трансплантхирургии Шарите, клиника Вирхова Хирургическая клиника, г. Брауншвейг
- Issue: Vol 4, No 4 (2011)
- Pages: 784-790
- Section: Original articles
- URL: https://vestnik-surgery.com/journal/article/view/443
- DOI: https://doi.org/10.18499/2070-478X-2011-4-4-784-790
- ID: 443
Cite item
Full Text
Abstract
The treatment of primary and secondary liver tumours has become more and more important over the last years, which is
probably due to the increasing incidence of hepatocellular carcinoma (HCC) and colorectal liver metastases. . Local tumour
therapy is an important alternative or complementary procedure to surgical resection. Radiofrequency ablation (RFA) is
the most significant one. The most severe constraint is re-occurrence at site of ablation. Whereas factors influencing local
recurrence rates have been determined, little is known about the timespan within local recurrence (LR) is to be expected, and
further treatment options. Between 01.01.2001 to 01.10.2008, 180 patients with 223 tumours ablations were examined . All
procedures were conducted under general anesthesia. The follow-up observation period lasted up until 15.11.2008. Due to the
high frequency of local tumour recurrence, a close follow-up every 3 month during the first year and every 6 month during
the second year, and thereafter once a year during the third, fourth and fifth year, is highly recommended. 223 RFAs in 180
patients were enrolled. Percutaneous access was chosen in 85 cases (47,2%), laparoscopic in 15 (8,3%) and open surgical in 80
cases (44,5%). Indications were primary liver tumors in 114 (63,3%) and metastases in 66 cases (36,7%). The presented study
shows that local tumour recurrence occurs more frequently in HCC with 72,5% compared to 48% in colorectal metastases.
The majority of LRs (71%) occurred within 9 months after the RFA despite observations beyond 2 years following the
treatment. However in all cases of local tumour recurence the further treatment either surgically or locally - usually with
RFA - was initially successful. 75% of LR could be treated by targeted interventions (RFA, n= 18, 53%, LITT-Laser-induced
Interstitial Thermotherapy, n=2,6%, brachytherapy, n=2, 6% or TACE-transarterial Chemoembolization, n=2,6%) or
resection (n=6,18%); 4 patients underwent liver transplantation (11%). Local recurrence can be considered rather common
after RFA. Follow-on treatment is feasible in approximately 75% of LR. Factors influencing the secondary success of repeated
procedures have yet to be determined.
About the authors
Клиника общей и висцеральной хирургии, г. Франкфурт-на-Одере
Клиника общей, висцеральной и трансплантхирургии Шарите, клиника Вирхова
Хирургическая клиника, г. Брауншвейг
Author for correspondence.
Email: author@vestnik-surgery.com
.
Клиника общей и висцеральной хирургии, г. Франкфурт-на-Одере
Клиника общей, висцеральной и трансплантхирургии Шарите, клиника Вирхова
Хирургическая клиника, г. Брауншвейг
Email: author@vestnik-surgery.com
.
References
- The treatment of primary and secondary liver tumours has become more and more important over the last years, which is probably due to the increasing incidence of hepatocellular carcinoma (HCC) and colorectal liver metastases. . Local tumour therapy is an important alternative or complementary procedure to surgical resection. Radiofrequency ablation (RFA) is the most significant one. The most severe constraint is re-occurrence at site of ablation. Whereas factors influencing local recurrence rates have been determined, little is known about the timespan within local recurrence (LR) is to be expected, and further treatment options. Between 01.01.2001 to 01.10.2008, 180 patients with 223 tumours ablations were examined . All procedures were conducted under general anesthesia. The follow-up observation period lasted up until 15.11.2008. Due to the high frequency of local tumour recurrence, a close follow-up every 3 month during the first year and every 6 month during the second year, and thereafter once a year during the third, fourth and fifth year, is highly recommended. 223 RFAs in 180 patients were enrolled. Percutaneous access was chosen in 85 cases (47,2%), laparoscopic in 15 (8,3%) and open surgical in 80 cases (44,5%). Indications were primary liver tumors in 114 (63,3%) and metastases in 66 cases (36,7%). The presented study shows that local tumour recurrence occurs more frequently in HCC with 72,5% compared to 48% in colorectal metastases. The majority of LRs (71%) occurred within 9 months after the RFA despite observations beyond 2 years following the treatment. However in all cases of local tumour recurence the further treatment either surgically or locally - usually with RFA - was initially successful. 75% of LR could be treated by targeted interventions (RFA, n= 18, 53%, LITT-Laser-induced Interstitial Thermotherapy, n=2,6%, brachytherapy, n=2, 6% or TACE-transarterial Chemoembolization, n=2,6%) or resection (n=6,18%); 4 patients underwent liver transplantation (11%). Local recurrence can be considered rather common after RFA. Follow-on treatment is feasible in approximately 75% of LR. Factors influencing the secondary success of repeated procedures have yet to be determined.
Supplementary files
