2 The procedure

2.1 Indications


Hepatocellular carcinoma is one of two common malignant tumours affecting the liver. The majority of malignant liver tumours are unsuitable for surgical excision because of their number, distribution and/or the presence of residual disease elsewhere. Therefore, a number of alternative treatments have been developed, of which RFA is one.

2.2 Outline of the procedure


RFA is a recently developed minimally invasive technique that destroys tissue by heating. Electrodes are inserted percutaneously into the tumour and current is applied to generate local heating and destroy tissue.

2.3 Efficacy

2.4 Safety


Complications of RFA are not common, but include hepatic abscess and injury to bile ducts. The rate of complications appears lower than that with alternative treatments. Evidence suggests a mortality rate of 1% or less. For more details refer to the overview, see sources of evidence considered by the committee.


The specialist advisors suggested the complication rate to be 3 to 5%.

2.5 Other comments


The committee noted that there was less evidence available about the safety and efficacy of RFA in treatment of colorectal metastases. Guidance for this indication will be postponed pending the publication of a systematic review by the Australian Medical Services Advisory Committee.