Call Us: +91 9825022073


Radiofrequency Ablation

Promising Efficacy and Safety of Radiofrequency Ablation

Surgical resection of all malignant cells is the gold standard in the management of solid tumors. However, surgical resection is not always an option, especially in the presence of coexistent morbidities or poor functional status of patients. In these patients, surgical resection may increase the morbidity and mortality.

Recently, thermal ablation procedures have turned out as feasible treatment options for several diseases. These procedures are proven to be as minimally invasive as in the cases of laser, microwave, cryoablation and radiofrequency ablation (RFA); and non-invasive as in high intensity focused ultrasound (HIFU). Of the thermal ablation methods, RFA is the most prevalent. It is used to treat a number of cancers within the liver, kidney, lung, bone, and breast tissues. Moreover it is used to treat cardiac disorders such as arrhythmias.


About the technique


RFA can be performed via different approaches


Application of RFA

1. Liver

RFA for the treatment of solid tumors involves its use with hepatic malignancies, both primary and metastatic. Currently, RFA is considered a first line treatment modality for local control of hepatocellular carcinoma in patients with Child-Pugh B or higher cirrhosis; indicated in patients with 3 or fewer tumors that are 3 cm or smaller; superior to percutaneous ethanol injection with regards to survival and local recurrence.

2. Lung

RFA is increasingly being applied to malignant lung nodules for local control as well as for palliation; feasibility and efficacy is becoming more established in the literature.

3. Bone Tumors

RFA has been long proven efficacious for the treatment of osteoid osteomas; done in the presence of typical clinical and radiographic characteristics of an osteoid osteomas; effective with minimal complication rates.

4. Kidney

RFA is used as less invasive and nephron-sparing techniques; can be useful among patients ; with only one kidney, multifocal disease, Von Hippel Lindau, limited renal function, elderly patients or patients with comorbidities that are poor candidates for surgery.

5. Breast

The role of RFA in breast cancer is still emerging; studies have established the feasibility; Complete coagulative necrosis is achieved in most of the patients and skin burn happens in a very small number of patients.

Rationale behind the importance of RFA in medical oncology

There is emerging evidence on the effective use of RFA in medical oncology. The following advantages provide strong support for its role in oncology:


Conclusion


Radiofrequency Ablation in Hepatocellular Carcinoma


Hepatocellular carcinoma (HCC) is the most common cause of cancer-related mortality all over the world. Liver transplantation or surgical resections, which are the curative therapies, are possible in only 20% of the patients. Although liver transplantation is ideal, there are several limitations like nonavailability of a suitable donor, cost and increased waiting period. Clinicians prefer surgical resection in such conditions. However, surgical resection can’t be performed in patients with cirrhosis as it limits the surgery. Moreover, there is a high probability of post-surgical liver failure.

Radiofrequency ablation (RFA) is considered as a first-line treatment modality for local control of hepatocellular carcinoma in patients with Child-Pugh B or higher cirrhosis where resection would have a higher associated mortality. It is considered to be better than percutaneous ethanol injection with regards to survival and local recurrence. RFA is suitable for those patients who are not candidates for resection or transplantation. RFA is performed safely in HCC via percutaneous, laparoscopic, or an open approach, even in patients with poor functional reserve.


The procedure includes 3 steps:

Step 1: The radiofrequency (RF) probe is inserted into the liver tumor.

Step 2: The electrode is connected to the RF generator. The surgeon deploys electrodes from the probe that deliver RF energy. This high heat causes death of tumor cells.

Step 3: The tumor cells are destroyed and will eventually be replaced by scar tissue.


Advantages:


Conclusion:

RFA is an effective treatment option for patients not suitable for resection or transplantation and for those with tumor size less than 3 cm. Chemoembolization with RFA can be useful in case of a larger tumor.


Radiofrequency Ablation in Lung Cancer


Surgical resection is considered as the gold standard in the management of lung cancer. However, in many cases, surgical resection is not possible owing to several limitations. It is clear from studies that only 30% of the primary lung cancer patients are eligible for surgery. Important reasons for this non-eligibility are poor functional status and associated chronic obstructive pulmonary disease. Presence of multiple lesions and advanced stage prevent the use of surgical resection among patients with metastatic lung cancer. Thus, radiofrequency ablation (RFA) is gaining importance in the management of lung cancer. The method of RFA of lung cancer is as follows:

The procedure is similar to that of lung biopsy. The procedure is done under CT (Computed Tomography) and real time CT (CT fluoro) guide to enable the placement of the needle precisely into the tumor. The steps are as follows:

Step: 1 The patient is placed under light to moderate sedation.

Step: 2 The radiofrequency probe is inserted into the tumor guided by imaging.

Step: 3 The electrtode is connected to the RF generator. The surgeon deploys electrode from the probe that deliver radiofrequency energy. This high heat causes death of tumor cells.

Step: 4 The tumor cells are destroyed and will eventually be replaced by scar tissue.

RFA Advantages: Current evidence


Conclusion:


Radiofrequency Ablation in Breast Cancer


Breast cancer is one of the most commonly diagnosed cancers in women. Breast cancer screening has also increased the diagnosis of breast cancer. Surgical management of breast cancer has changed dramatically over the years. The trend has changed from mastectomy to breast preserving techniques in small breast cancer lesions. Breast preserving techniques have become preferable to both surgeons as well as patients. These non-surgical techniques potentially provide non-invasive, cosmetically pleasing results. Owing to these changes, radiofrequency ablation (RFA) has become an increasing area of internet in the management of breast cancer.


The technique of RFA of the breast is as follows:

Advantages:


Conclusion: