Radiofrequency Ablation of Liver Tumors

Procedure overview

In radiofrequency ablation (RFA) of liver tumors, electricity is sent right into a tumor. Then high levels of heat are used to destroy cancer cells. RFA uses a needle electrode guided by an imaging scan to help treat the cancer. These can include a CT scan, MRI, or ultrasound.

This test can't be done in all cases. For instance, RFA would not normally be recommended in the following cases:

• The tumor is large (typically over 5 cm, or about 2 inches, across) 

• The tumor is close to blood vessels. This is due to the chance of thermal injury and damage to the vessels.

Reasons for the procedure

RFA may be used for the following cancers:

• Hepatocellular carcinoma. This is a cancer that starts in the liver.

• Colon cancer that’s spread, or metastasized, to the liver. 

RFA is commonly used to treat cancer in the liver when surgery isn’t a good option. It’s most often used to treat liver tumors that are relatively small in size.

RFA is often used instead of surgery to remove the tumors when:

• Surgery would be high-risk because of other health issues

• The liver tumors are small

• A number of small tumors are spread out across the liver

• The tumor is in a place that makes it hard to reach through surgery

• Surgical removal of the tumor would destroy too much of the liver

• Liver tumors have grown back after surgery

• Liver function is poor

This treatment is not a cure. But survival rates from RFA may be just as good as those in people with small tumors who had surgery.

Risks of the procedure

As with any procedure, RFA carries risks:

• Infection

• Injury to organs near the liver

• Gallbladder inflammation or damage to the bowels or bile ducts

• Extreme pain

• Abscess at the cut in the skin

• Flu-like symptoms that start three to five days later. This is called post-ablation syndrome.

• Bleeding

• Damage to blood vessels

RFA may cause a small amount of radiation exposure if a CT scan is used. The risks related to radiation exposure are quite low.

There may be other risks. These depend on your health condition. Talk about your concerns with your healthcare provider before the procedure.

Before the procedure

• Your healthcare provider will do tests and talk about the procedure with you. You may need blood tests to see how well your kidneys and liver are working. You may also need tests to make sure that your blood is clotting well.

• Tell your healthcare provider about any allergies, recent illnesses or infections, and any chronic health issues you have.

• Tell your healthcare provider about all the medicines, herbs, and supplements you’re taking. He or she may recommend that you stop using some medicines for a short time before RFA. These include blood thinners, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen.

• Your healthcare provider may tell you not to eat or drink anything starting the night before RFA.

• You should make plans for someone to drive you home after the procedure.

During the procedure

RFA of liver tumors will likely follow these basic steps:

• You’ll lie on an exam table. You’ll receive an IV in your hand or arm. Your healthcare team will give you medicine through this line.

• Your healthcare team will track your blood pressure, heart rate, and pulse.

• RFA may be done while you’re awake or while you’re under general anesthesia. If you’re awake, your healthcare provider will numb the place on your body where he or she will do the procedure.

• Your healthcare provider will make a small cut in your skin. This is done to insert the needle electrode. He or she will use an imaging scan, such as a CT, MRI, or ultrasound, to guide the needle electrode into the liver tumor.

• An electrical current will pass through the electrode to destroy the tumor. Sometimes, the electrode may need to be moved around to different parts of the tumor to reach all of it.

• Once the procedure is done, your healthcare provider will take out the electrode and the IV line. You’ll get a bandage over the site.

After the procedure

The procedure takes up to a few hours to do. You should be able to go home within a few hours after it.

You may have pain and nausea after RFA. These side effects are usually mild and can be controlled with medicines. Within about a week, you should feel back to normal and be able to return your daily activities. Call your healthcare provider if you have any problems from the procedure.