There are multiple applications of RFA and it can be used in combination with resection and hepatic artery infusion pump.

• Multiple bilateral metastasis

• Lesions in approximation of hepatic veins, portal vein, inferior vena cava

• Lesions at lines of resection

For example, patient with extensive bilateral tumors would be considered unresectable; however a left lobectomy with ablation of the right-sided tumors is possible. The probe can be used on tumors that abut the hepatic and portal veins without damage to these structures. RFA will however ablate bile ducts and should be avoided if major compromise of the main biliary system is possible.

A study of 123 patients using RFA showed tumor recurrence in 2% of patients; however metastatic disease occurred in 28% at 15 month median follow-up. Bowles et al report a 9% local failure rate. Complication rates range from 2.4% to 10% with an average length of stay is 3 days.

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