Radiofrequency ablation of large size liver tumours using novel plan-parallel expandable bipolar electrodes: Initial clinical experience |
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Authors: | Martijn R. Meijerink Petrousjka van den TolAukje A.J.M. van Tilborg Jan Hein T.M. van WaesbergheSybren Meijer Cornelis van Kuijk |
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Affiliation: | a Department of Radiology, VU University Medical Centre, Amsterdam, The Netherlands b Department of Surgical Oncology, VU University Medical Centre, Amsterdam, The Netherlands |
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Abstract: | PurposeAlthough radiofrequency ablation (RFA) is a promising method for local treatment of liver malignancies, with conventional monopolar systems recurrence rates for large size tumours (≥3.5 cm) remain high. The objective of this study was to evaluate the safety, feasibility and local effectiveness of a novel bipolar plan-parallel expandable system for these larger tumours.Methods and materialsEight consecutive patients with either unresectable colorectal liver metastases (CRLM in 6 patients), carcinoid liver metastases (1 patient) and hepatocellular carcinoma (HCC in 1 patient) of ≥3.5 cm were treated with bipolar RFA during laparotomy with ultrasound guidance. Early and late, major and minor complications were recorded. Local success was determined on 3-8 month follow-up CT scans of the upper abdomen.ResultsNine CRLM, one carcinoid liver metastases and one HCC (3.5-6.6 cm) were ablated with bipolar RFA. Average ablation time was 16 min (range 6-29 min.). Two patients developed a liver abscess which required re-laparotomy. In both cases bowel surgery during the same session probably caused bacterial spill. There were no mortalities. The patients were released from hospital between 5 and 29 days after the procedure (median 12 days). The 6-12 month follow-up PET-CT scans showed signs for marginal RFA-site tumour recurrence in three patients with CRLM (3/11 lesions).ConclusionPreliminary results suggest bipolar RFA to be a reasonably safe, fast and feasible technique which seems to improve local control for large size hepatic tumour ablations. |
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Keywords: | Liver tumours Radiofrequency ablation (RFA) Interventional |
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