What Is Radiofrequency Ablation of Liver Tumors?

Radiofrequency ablation is one of several established methods of destroying liver tumors without removing them surgically.

Liver ablation surgery is a procedure that destroys liver tumors without surgically removing them. The technique can be used in people with:

• Early-stage liver cancer
• Primary liver tumor that cannot be operated
• Poor general health and metastatic growths
• Multiple small tumors waiting for liver transplantation
• Reduced liver function 
• Liver tumors that are metastatic (spread to other organs), who are not fit for surgery

Ablation may be avoided if:

• There are multiple and/or large tumors. 
• Tumors near important structures like major blood vessels, the diaphragm or major bile ducts. Ablation is not a good choice in such cases as it often destroys some of the normal tissue around the tumor.

Although ablation techniques are less likely to cure cancer than surgery, they can be helpful for people who are unfit for major surgery. Liver ablation treatments may also sometimes be used in patients waiting for a liver transplant.

Tumors less than 3 cm across (a little over an inch) are most suitable for treatment by ablation. If the tumor is slightly larger (1-2 inches, or 3-5 cm across), ablation may be used along with embolization (surgically blocking the blood supply to the tumor).  

Depending upon the technique used to destroy the tumor cells, the various ablation techniques can be categorized as:

• Radiofrequency ablation (RFA) uses high-energy radio waves to destroy the tumor.
• Microwave ablation (MWA) uses the energy from electromagnetic waves to heat and destroys the tumor.
• Cryoablation (cryotherapy) destroys a tumor by freezing it.
• Ethanol (alcohol) ablation destroys tumors by injecting concentrated alcohol directly into them.

Liver ablation is not a major surgery. For this surgery, you may need to stay a few hours in a hospital. Usually, ablation of liver tumors can be done without open surgery (a large incision). A needle or probe is inserted into the tumor through the skin (percutaneous ablation of liver tumor). Rarely, however, to be certain the treatment is aimed at the right place, the ablation may be done under general anesthesia. Some cases may need a surgical incision to remove the part of the liver containing the tumor (partial hepatectomy).

Radiofrequency ablation of liver tumors is one of the commonest ablation methods for small tumors of the liver. In this technique, high-energy radio waves are used to destroy the tumor cells. The procedure involves inserting a thin, needlelike probe into the tumor through the skin (percutaneously). The needle is guided to the tumor under image guidance (ultrasound or CT scan). This is followed by passing high-frequency current through the tip of the probe to heat the tumor and destroy the cancer cells. This procedure is an accurate, quick and cost-effective method for managing tumors in the liver. 

Several studies report that RFA is a relatively low-risk procedure with fewer complications. The possible side effects of RFA include:

• Fever
• Abdominal pain
• Bodyache
• Nausea
• Vomiting
• Shoulder pain
• Cholecystitis (gall bladder inflammation)
• Damage to the bile ducts
• Damage to the bowel
• Bleeding
• Hemoperitoneum (collection of blood in the peritoneal cavity- the space between your abdominal organs and inner abdominal wall)
• Pneumothorax (presence of air in the space between the lungs and the chest wall)
• Hemothorax (abnormal collection of blood in the chest)
• Hydrothorax (abnormal collection of watery fluid in the chest)
• Pleural effusion (collection of pus between the lungs and their covering [pleura])
• Ascites (abnormal collection of fluid inside the abdomen)
• Blood clot formation
• Infections 
• Liver abscess (collection of pus in the liver)
• Needle-tract seeding (spillage and growth of cancer cells along the path of the ablation needle)
• Injuries