Doctors at Thomas Jefferson University Hospital are using a new technique to essentially “melt” away cancerous liver tumors. The technique, called radiofrequency tumor ablation, promises faster, more specific treatment with fewer side effects and shorter hospital stays than with standard therapies.

Radiofrequency treatment delivers electrical energy through a special catheter to the tumor. The heated cancer cells die within a day and a half.

The new technique is significant because about 80 percent of liver tumors cannot be surgically removed at diagnosis. Other options include chemotherapy, which has limited effectiveness, and cryosurgery, which entails freezing tumors.

While generally an effective treatment, cryosurgery keeps patients in the hospital for several days and can produce side effects, says Ernest L. Rosato, MD, Assistant Professor of Surgery at Jefferson Medical College (JMC).

“Radiofrequency ablation gives us a huge advantage over cryosurgery,” he says. Cryosurgery involves freezing tumor cells to reduce tumor size, he explains.

With radiofrequency ablation, Dr. Rosato says, “We can do what we do with cryosurgery but with fewer side effects. Patients can even have this treatment while they are also receiving chemotherapy. It’s a minimally invasive way of dealing with tumors.”

The liver is a frequent site to which cancer spreads, particularly from the colon. Cancer is most dangerous when it goes to other areas in the body.

“Frankly, many patients who come to us are almost hopeless candidates,” says Francis E. Rosato, MD, The Samuel D. Gross Professor of Surgery and Chairman of the Department, JMC.

“Patients for whom chemotherapy has failed are looking to have their tumors treated,” he says. “We would like to see them earlier, after chemotherapy, rather than waiting until they get into late stages of disease.”

He calls radiofrequency ablation “revolutionary in terms of minimizing patient risk, loss of ability to work, and expense.”

He is amazed at how well patients have done to date. “What’s ‘Melt’ continued from page 1 striking is that every patient we’ve treated wakes up and asks if they can go home. It is extraordinary how patients are tolerating this treatment.”

Some patients can be treated with the new technique under conscious sedation. Most patients are seen as outpatients.

Donna Barbot, MD, Clinical Associate Professor of Surgery, JMC, is another member of the team that applies this form of therapy, as well as cryoablation, to appropriate patients. In additon, both treatment modalities depend upon the cooperation and interaction of the ultrasound team to localize and direct the placement of probes. Laurence Needleman, MD, Associate Professor of Radiology, JMC, is the individual from the Division of Ultrasound most involved in these activities.

“We’re treating some patients whom we couldn’t have treated in the past, such as those with esophageal cancer that has spread to the liver,” adds Dr. Ernest Rosato, who is Dr. Francis Rosato’s son. Still, for now, no one knows the long-term impact of radiofrequency ablation treatment on patients’ health.

“We don’t know what the ultimate results will be,” Dr. Ernest Rosato says. “It will take us several more years to document the efficacy of this program.”

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