Medical Device Link.

Originally Published MX March/April 2006

COVER STORY

As physicians continue to employ radio-frequency ablation (RFA) for the thermal ablation of nonresectable liver tumors, a growing published body of evidence-based medicine is supporting the clinical adoption of RFA for other applications.

At the annual meeting of the Radiological Society of North America (Oak Brook, IL) in November 2005, several papers were presented that demonstrate the safety and efficacy of RFA for treating patients with renal, lung, and other tumors. According to RITA Medical (Fremont, CA), these papers also reflect the determination among physicians to expand the use of RFA in the treatment of cancer.

In one such paper, titled "Radio-Frequency Ablation of Pulmonary Tumors Response Evaluation (RAPTURE) Trial: Two-Year Survival Outcomes," author Riccardo Lencioni, MD, a professor of radiology at the University of Pisa (Italy), presented data from a study in which 186 lung tumors were treated in 106 patients. Three months after RFA therapy, computed-tomography scans showed the complete ablation of 173 of 186 tumors. Cancer-specific two-year survival rates for the subset of patients with non-small-cell lung cancer stood at 91%. This ratio was 72% for patients with colorectal metastases. No procedure-related deaths occurred. Both survival statistics compare favorably with study results examining radiation and chemotherapy treatments.

A separate retrospective review focused on the ablation of 25 renal tumors in 21 patients. In the study, "Radio-Frequency Ablation of 25 Renal Masses in Patients with Solitary or Functionally Solitary Kidneys: Trends in Creatinine Levels with and without Obstructive Complications," author Debra Gervais, MD, director of abdominal and interventional radiology at Massachusetts General Hospital (Boston) and an assistant professor of radiology at Harvard Medical School (Boston), reported that complete ablation was demonstrated in 23 of the 25 tumors. No local tumor recurrences were reported within a nearly three-year follow-up period.

In November 2005, the American Medical Association (AMA; Chicago) assigned a new current procedural terminology (CPT) code for the percutaneous RFA of renal tumors, simplifying the way physicians receive reimbursement for the procedure. While the ablation of renal tumors has not yet been cleared by FDA, AMA's move nonetheless validates the acceptance of the procedure among physicians.

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