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| Vol. 22, No. 20 |
| November 1, 2000 |
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Doctors at St. Luke's Use New Device to "Cook" Liver Cancers
By CHRIS FERRIS St. Luke's Episcopal Hospital
Surgeons at St. Luke's Episcopal Hospital's Texas Liver Institute are using a new, state-of-the art device to "cook" certain liver cancers, much like a microwave cooks food. The device, called Radiofrequency Interstitial Tumor Ablation (RITA), offers an option for treating some liver tumors that would not have been treatable in the past. Patients treated with radiofrequency ablation have shorter hospital stays and fewer complications than those treated by surgically removing the cancerous portion of the liver. St. Luke's was the first Houston-area hospital to purchase and use the RITA device. To date, more than 20 patients have been successfully treated. The RITA device works on the same principle as electrocautery used in surgery to coagulate blood vessels. Using ultrasound, the RITA probe is inserted into the tumor and the prongs of the device are extended. The tissue is then heated to 108 degrees Celsius to destroy the tumor and a small margin of normal liver tissue surrounding the tumor. The tumor is "cooked" for 10 to 30 minutes, depending on size. Larger tumors may require surgeons to reposition the probe and repeat the procedure two or three times to ensure that the entire tumor is destroyed. Over time, the destroyed tissue is absorbed by the body. "More than 15,000 Americans will be diagnosed with liver cancer this year. Unless they are treated with surgery or radiofrequency ablation, few will be alive in two years," said Dr. R. Patrick Wood, the institute's surgical director. Conventional surgical procedures cannot be used in up to 80 percent of liver cancer patients, Dr. Wood said. "RITA offers a new option for some patients with multiple liver cancers, cancers in both sides of the liver and for patients, like those with cirrhosis, who could not tolerate removal of a part of the liver," he explained. "Even with conventional surgery, up to 70 percent of patients may experience a recurrence of the tumor and further surgery may be impossible. Some of these patients may now be treated with RITA." Another option to treat liver cancers is chemotherapy, which fails to cure most liver cancers and may have significant side effects. Cryosurgery, where a device is used to freeze the cancerous tumor, is also an option, but has been largely abandoned in favor of radiofrequency ablation, which has far fewer side effects. Still another technique is to inject the tumor with concentrated alcohol solution; but this technique may cause severe pain, and is limited by the amount of alcohol that can be injected at any time. Transplantation of the liver is not an option for most patients who have metastatic liver cancer, where the cancer has spread to other sites in the body. Patients who have cirrhosis and develop a primary liver cancer that has not metastasized, however, are excellent patients to treat with a transplant, provided their cancer is small enough and they have no more than four cancerous tumors. "Unfortunately, the waiting time to get a new liver averages almost two years," Dr. Wood said. "In the past, since most of these patients could not tolerate a major liver operation to remove the cancerous tumor, little could be done to stop the tumor from growing while the patient waited for a donor liver. The vast majority of those patients would eventually have to be removed from the liver transplant waiting list because their tumors would grow too large and spread before a donor liver could be located. Now, these patients can undergo radiofrequency ablation to destroy the cancer and prevent it from growing as they wait for a donor liver to become available for them."
©2006 Texas Medical Center E-Mail: tmcinfo@texmedctr.tmc.edu URL: http://www.tmc.edu/tmcnews/11_01_00/page_07.html |
