Radiofrequency Ablation (RFA) Therapy of Liver

  • Medical Author:
    Tse-Ling Fong, MD

    Dr. Fong is the Medical Director of the USC Liver Transplant Program and Associate Professor of Medicine at the USC Keck School of Medicine. He obtained his medical degree from the University of Southern California and completed his residency in Internal Medicine at Los Angeles County-USC Medical Center. He is board certified in Internal Medicine and the subspecialty of Gastroenterology.

  • Medical Editor: Paul Oneill, MD,Board Certified Oncology
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When do surgeons do radiofrequency ablation (RFA)?

In the U.S., radiofrequency ablation (RFA) therapy has become the ablation (tissue destruction) therapy of choice among surgeons for treating otherwise inoperable liver cancer (HCC). The surgeon can perform this procedure laparoscopically (during an operation performed with tools introduced through small holes in the abdominal wall) or during open exploration of the abdomen. In some instances, the procedure can be done without opening the abdomen by just using ultrasound for visual guidance.

How is RFA done and how does it work?

In RFA, heat is generated locally by a high frequency, alternating current that flows through the electrodes. A probe is inserted into the center of the tumor and the non-insulated electrodes, which are shaped like prongs, are projected from the central probe into the tumor. The local heat that is generated melts the tissue (coagulative necrosis) that is adjacent to the probe. The probe is left in place for about 10 to 15 minutes. The whole procedure is monitored visually by ultrasound scanning.

What size tumor is treated by RFA?

The ideal size of an HCC tumor for RFA is less than 3 cm. Larger tumors may require more than one session.

What is the benefit of RFA therapy?

This treatment should be viewed as palliative, that is, it can shrink a tumor and provide some relief of symptoms, but it is generally not curative. Cancer cells usually also exist outside the area being treated, and the cancer comes back either elsewhere in the liver or in other locations in the body and ultimately result in the death of the patient.

Medically reviewed by Jay B. Zatzkin, MD; American Board of Internal Medicine with subspecialty in Medical Oncology

REFERENCES:

Brown DB, Geschwind JF, Soulen MC, Millward SF, Sacks D. Society of Interventional Radiology position statement on chemoembolization of hepatic malignancies. J Vasc Interv Radiol. 2006 Feb;17(2 Pt 1):217-23.

Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005 Nov;42(5):1208-36.

Garden OJ, Rees M, Poston GJ, Mirza D, Saunders M, Ledermann J, Primrose JN, Parks RW. Guidelines for resection of colorectal cancer liver metastases. Gut. 2006 Aug;55 Suppl 3:iii1-8.

Previous contributing medical editor: Leslie J. Schoenfield, MD, PhD

Medically Reviewed by a Doctor on 5/1/2015

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