Cancer in the liver has traditionally been approached with surgical resection or chemotherapy given intravenously. Recently techniques for the local ablation of liver tumors have become popular. These techniques may avoid an open operation and may, in some cases, be safer than surgical removal of the tumors. Local ablation has been studied in many forms including microwave, laser, high intensity focused ultrasound, local injection of alcohol or chemotherapy, and cryotherapy. The thermal ablation of tumors involves heating the tumors to extremely high temperatures until the tumor cells die. This heating can be performed simply and reliably using radiofreqency waves in a technique called radiofrequency ablation (RFA). This technique has already been extensively studied and has shown to be a safe and reliable means of ablating liver tumors. This procedure can be performed as an open operation or at the time of laparoscopy. The tumor is identified using an ultrasound probe placed on the liver. The needle tip radiofrequency probe is then inserted into the tumor and the heating is begun. Care must be taken to make sure that all margins of the spherical tumor are heated to an appropriate temperature to allow for a complete ablation of the tumor. This requires moderate experience to be successful with this technique. The radiofrequency approach has the added benefit of preventing bleeding as the heat cauterizes blood vessels and destroys them.

While this technique is exciting and potentially much easier on the patient, it must be considered only one tool in the armamentarium of treatment for liver tumors. In some cases, a combination of surgical removal and radiofrequency ablation may be the best approach. These decisions are made after carefully examining the extent and location of tumors within the liver.