Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Freeze or fry—cryoablation or radiofrequency ablation in liver surgery?

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 472–473 (2007)Cite this article

Local ablation has a place in the therapeutic arsenal for the treatment of liver tumors; however, as with many new techniques, local ablation is widely applied despite an absence of evidence. Why is local ablation needed for the treatment of liver tumors? The answer is to increase the number of patients with liver tumors who are surgically treatable.

Many circumstances preclude the use of partial liver resection to render the liver tumor-free. These include the occurrence of bilobar liver tumors, the inability to resect tumor recurrences after previous partial liver resection, and the presence of comorbidities in the generally older patient population who have (metastatic) liver cancer. Furthermore, patients with hepatocellular carcinoma often have underlying cirrhosis that precludes partial liver resection, and, therefore, locoregional interventions such as ablation are the only remaining therapeutic possibilities.1 Another indication for local ablation is to stop tumor progression in patients with hepatocellular carcinoma who are awaiting liver transplantation. In addition, but rarely, ablation of liver tumors that are hormonally active or those that can be treated by additional means such as radioactive iodine therapy (thyroid carcinoma metastases) can offer palliation and improve life expectancy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Hong K et al. (2006) Technology insight: image-guided therapies for hepatocellular carcinoma–intra-arterial and ablative techniques. Nat Clin Pract Oncol 3: 315–324

    Article  Google Scholar 

  2. Pearson AS et al. (1999) Intraoperative radiofrequency ablation or cryoablation for hepatic malignancies. Am J Surg 178: 592–599

    Article  CAS  Google Scholar 

  3. Adam R et al. (2002) A comparison of percutaneous cryosurgery and percutaneous radiofrequency for unresectable hepatic malignancies. Arch Surg 137: 1332–1339

    Article  Google Scholar 

  4. Bilchik AJ et al. (2000) Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms: a proposed algorithm. Arch Surg 135: 657–662

    Article  CAS  Google Scholar 

  5. Chapman WC et al. (2000) Hepatic cryoablation, but not radiofrequency ablation, results in lung inflammation. Ann Surg 231: 752–761

    Article  CAS  Google Scholar 

  6. Ng KK et al. (2004) Comparison of systemic responses of radiofrequency ablation, cryotherapy, and surgical resection in a porcine liver model. Ann Surg Oncol 11: 650–657

    Article  Google Scholar 

  7. Elias D et al. (2004) Local recurrences after intraoperative radiofrequency ablation of liver metastases: a comparative study with anatomic and wedge resections. Ann Surg Oncol 11: 500–505

    Article  Google Scholar 

  8. Permpongkosol S et al. (2007) Thermal maps around two adjacent cryoprobes creating overlapping ablations in porcine liver, lung, and kidney. J Vasc Interv Radiol 18: 283–287

    Article  Google Scholar 

  9. Baust JG et al. (2004) Cryosurgery–a putative approach to molecular-based optimization. Cryobiology 48: 190–204

    Article  CAS  Google Scholar 

  10. Khajanchee YS et al. (2004) A mathematical model for preoperative planning of radiofrequency ablation of hepatic tumors. Surg Endosc 18: 696–701

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Department of Hepato-Pancreato-Biliary Surgery & Liver Transplantation, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, The Netherlands k.p.de.jong@chir.umcg.nl

Authors and Affiliations

  1. KP de Jong is an Associate Professor of Surgery in the Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation at the University Medical Center Groningen, Groningen, The Netherlands.,

    Koert P de Jong

Authors
  1. Koert P de Jong
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Jong, K. Freeze or fry—cryoablation or radiofrequency ablation in liver surgery?. Nat Rev Gastroenterol Hepatol 4, 472–473 (2007). https://doi.org/10.1038/ncpgasthep0905

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpgasthep0905

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing