Radiofrequency ablation of large size liver tumours using novel plan-parallel expandable bipolar electrodes: initial clinical experience.
OBJECTIVE
Although 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
Eight 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.


RESULTS
Nine 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).


CONCLUSIONS
Preliminary 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.
Meijerink
Martijn R
MR
Department of Radiology, VU University Medical Centre, Amsterdam, The Netherlands. mr.meijerink@vumc.nl
van den Tol
Petrousjka
P
van Tilborg
Aukje A J M
AA
van Waesberghe
Jan Hein T M
JH
Meijer
Sybren
S
van Kuijk
Cornelis
C
D000368:Aged; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004566:Electrodes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome