Role of percutaneous radiofrequency ablation in treatment of liver malignancies
Mahmoud Mohamed abd alwahab, Mohamed Abd Alaleem Nafady, Tarek Mohamed Mohamed Mansour, Ahmed Kasem Mohamed
Background: Hepatocellular carcinoma (HCC) and metastases from colorectal carcinoma are the two most common malignant tumors to affect the liver. When these tumors are left untreated, the prognosis for both is dismal, with essentially 100% mortality at 5 years. Conventional therapies such as systemic chemotherapy or radiation have proven ineffective. Objective: Evaluation of the safety, efficacy of radiofrequency ablation in treatment of liver malignancies that fulfill its established parameters.Patients and Methods: This experimental non-randomized study was carried between (January 2019 and October 2019) in collaboration with Medical and trpoical medicine Department. Twenty patients with hepatic malignancies were treated by ultrasound-guided percutaneous radiofrequency ablation. Results: In our study, Boston RF 3000 system was used for treatment of liver tumors. Energy is delivered from the generator to the target tissue by a 14-gauge needle that has twelve hook shaped electrodes inside and the system offers the advantage of an electrical measurement of tissue impedance. Twenty patients with Twenty four focal lesions were treated by twenty seven RFA sessions are divided the size of the focal lesion into two groups, group A (patients with focal lesions less than 3cm) fourteen patients with eighteen focal lesions were treated by eighteen RFA sessions; complete ablation was (88.9%), recurrence was (11.1%) and no residual detected, Group B (patients with focal lesions (3-5cm)) six patients had six focal lesions were treated by nine RFA sessions, complete ablation was (50%), residual was (33.3%), recurrence (16.6%). Conclusion: There are several guidelines to assess treatment response in patients with HCC, including the World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), and European Association for the Study of the Liver (EASL), or modified RECIST (mRECIST) criteria. The Liver Imaging Reporting and Data Systems (LI-RADS), is an extensive approach to categorize and assess residual or recurrent malignancy, including after loco regional therapies. Specifying response criteria with definitions, examples and a precise algorithm, LIRADS guidelines are designed to standardize the response assessment and improve communication within HCC multidisciplinary teams, both for clinical practice and clinical trials.