Hope for liver cancer sufferers?
More than 85% of liver cancer patients have advanced disease or other complications that make traditional surgical removal of their tumours impossible. Without surgery, most patients die within two years, and only about 2% survive five years.
More than 85% of liver cancer patients have advanced disease or other complications that make traditional surgical removal of their tumours impossible. Without surgery, most patients die within two years, and only about 2% survive five years.
Since removal of all viable tumour tissue is believed to improve survival rates for patients whose cancer is restricted to the liver, alternative methods of treating inoperable tumours are being developed. ECRI's just-published technology assessment report found that one new treatment option, radiofrequency ablation (RFA), safely and effectively destroys liver tumors in patients who are not eligible for traditional surgery. However, existing evidence does not yet conclusively support the effectiveness of RFA for improving long-term patient survival rates. RFA is one of several focal ablation technologies that destroy liver tumours while preserving the surrounding nondiseased liver tissue. The new technique uses a needle electrode to deliver a high-frequency alternating current directly into liver tumours. Vibrations from the current generate heat that targets and kills tumour tissue. According to ECRI's report, RFA safely and effectively destroys both primary and metastatic liver tumours and is about as effective in killing tumours as other focal ablation technologies such as cryosurgery or laser ablation.
However, ECRI's analysis of published research found that even if all tumours are destroyed, tumor recurrence or new tumour development occurs in some cases. This raises the possibility that RFA may ultimately have only minimal impact on long-term patient survival rates. Some evidence suggests that RFA may increase the chances of survival in some patients with hepatocellular carcinoma (HCC), the most common type of primary liver cancer, but no existing data supports a similar conclusion for metastatic liver cancer. More evidence from studies of both types of liver cancer is needed before firm conclusions can be drawn about the effect of RFA on long-term patient survival.
ECRI's assessment addressed five key issues in determining the effectiveness and safety of RFA to treat primary and metastatic liver cancer: survival, quality of life, tumour response rates, tumour recurrence rates, and treatment-related mortality and morbidity rates.