|
Radiofrequency ablation is a treatment that
can be applied to some liver tumors that are
unresectable. The technique involves placement
of a thin electrode (similar to a needle)
into the center of a liver tumor, usually
with the assistance of either CAT scan or
ultrasound imaging. The electrode can be inserted
through the skin often times, such that an
operation is not required, much as a liver
biopsy can be performed without the need for
an operation. Local anesthesia is commonly
used to minimize the discomfort of electrode
insertion. The electrode is then connected
to an electrical generator, and as current
passes from the electrode tip to a grounding
pad, the tumor is heated to a point where
it is destroyed. This portion of the procedure
generally does not produce any discomfort.
During the procedure, vital signs, tumor temperature,
and electrical properties of the tumor are
monitored. The efficacy of treatment is assessed
by CAT scan one month following treatment.
Re-treatments are often necessary. Risks of
the procedure include bleeding, although this
is extremely rare.
In November of 1996, Dr. Kenneth Tanabe
and Dr. Nahum Goldberg performed the first
radiofrequency ablation of a patient with
a liver tumor in the United States. This
history-making procedure was performed
in the operating rooms of the Massachusetts
General Hospital as part of an Institutional
Research Board approved clinical research
protocol. The experimental procedure was
deemed a success in both efficacy and
safety. Following this initial trial,
researchers in the Division of Surgical
Oncology at the Massachusetts General
Hospital have continued to lead the way
in making cutting edge advances in this
field. Nonetheless, it is important to
point out that:
- radiofrequency ablation remains experimental
- radiofrequency ablation is not a substitute
for resection (surgical removal) whenever
possible, as removal of the tumor
is considered the "gold standard"
for treatment in appropriate patients
- the chances of successful (complete)
tumor destruction is about 75% --
less for tumors larger than 3 cm and
more for tumors smaller than 3 cm
- it is exceedingly rare that pateints
with liver metastases from cancer
of the pancreas, lungs, stomach, or
esophagus are candidates for radiofrequency
ablation unless they have no more
than two tumors measuring no more
than 4.0 cm in size.
Dr. Tanabe and colleagues are setting up
a national trial of this technique sponsored
by the American College of Surgeons and
the National Cancer Institute.
If you feel that you may be a candidate
for radiofrequency ablation of your liver
tumor, please have your physician contact:
Kenneth Tanabe, MD at 617-724-3868
James C. Cusack, MD at 617-724-4093
Kenneth K. Tanabe, MD
Associate Professor of Surgery, Harvard Medical
School
Chief, Division of Surgical Oncology, Massachusetts
General Hospital
Deputy Clinical Director, Massachusetts General
Hospital Cancer Center
James C. Cusack, MD
Assistant Professor of Surgery, Harvard
Medical School
Surgical Director, Tucker Gosnell Center
for Gastrointestinal Cancers
|
