Journal articles this month include a comparison of anesthesia required for RFA versus cryoablation and a new method to protect adjacent tissues from thermal injury.
Lung carcinoma remains the leading cause of cancer death in the U.S. Over the past decade, lung cancer death rates have more than quadrupled, from 5.4 to 29.4 per 100,000.1 The American Cancer Society estimates that in 2005 the number of lung cancer deaths will rise to 163,510-90,490 men and 73,020 women-accounting for 28% of all cancer-related deaths. The number of newly diagnosed lung cancers will rise to 172,570, or 93,010 new cases in men and 79,560 in women.2 Nearly 60% of those diagnosed with lung cancer die within one year of their diagnosis and nearly 75% within two years.2
Over 35,000 new cases of renal cell carcinoma occurred in the U.S. in 2001,1 most of them detected as incidental imaging findings on CT, MR, or ultrasound.2,3 Since most of these tumors are relatively small when detected, the classic clinical triad of flank pain, hematuria, and palpable mass is now rarely encountered. Many of these incidentally discovered RCCs are also slow growing. Bosniak et al showed that RCCs smaller than or equal to 3.5 cm grow at an average rate of 0 to 1.1 cm/year (mean 0.36 cm/year).4
Reimbursement for radiofrequency ablation of tumors continues to broaden, with local Medicare agencies and most major insurers covering the procedure for unresectable liver neoplasms. Palliative RFA treatment of bone metastases follows as the next most widely accepted procedure. These positions are bolstered by existing CPT codes for the treatments.
As more medical practitioners accept RFA and other tumor ablation methods for cancer treatment, physicians must determine how to integrate the procedure into their practices. The leap from academia to a clinical setting may be perilous, as tumor ablation doesn’t fit neatly into any one specialty. Does RFA belong in the interventional radiology box, the surgery box, or the oncology box?
Recent journal articles review the progress of tumor ablation therapies in the liver, breast, lung, and kidney.
Recent journal articles dealing with tumor ablation therapy compare the effectiveness of different ablation methods, evaluate side effects and other dangers inherent in the procedure, look at the uses of the procedure in treating bone, liver, and kidney tumors, and more. Following is a roundup of the news.
Fusion imaging is making inroads as an imaging strategy for RFA and other tumor ablation techniques. The sophisticated melding of functional and structural imaging modalities allows physicians to more accurately map out the procedure beforehand and monitor the results afterward. A few software packages allow physicians to check their real-time progress against preprocedural images, and new products and procedures to automate the process are being developed.
Journal articles published since the beginning of this year
look at new treatment modalities, provide more evidence of ablation’s efficacy,
and identify potential complications. Imaging technologies and combination
therapies are also covered.
The case for radiofrequency ablation and other forms of tumor ablation has been made: Use of the technique is established for treating bone lesions and tumors of the liver, lung, kidney, and other organs. Now the focus turns to expanding the realm of treatment and pushing the limits of the technology. Two areas taking center stage are tumor size and the choice between RFA and cryoablation.