Interventional oncology is a subspecialty field of interventional radiology that deals with the diagnosis and treatment of cancer and cancer related problems using targeted minimally invasive procedures performed under imaging guidance .
Hepatocellular carcinoma ( HCC) is the most common primary malignancy of adults , in Egypt liver cancer forms 11.75 % of the malignancies of all digestive organs .
HCC constitutes 70.48 % of all liver tumors among Egyptians ( Menoufia University ).
Al-Khalig medical as one of the leading companies in the Egyptian market emphasizing on interventional oncology .
Realized the importance of introducing such as radiofrequency ablation ( RFA) , Microwave ablation ( MWA) and NanoKnife .
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Radiofrequency ablation for inoperable liver tumors , radiofrequency ablation ( RFA ) offers a nonsurgical , localized treatment that kills the tumors cells with heat , while sparing the healthy liver tissue .
Thus , this treatment is much easier on the patient than systemic therapy .
Radiofrequency energy can be given without affecting the patients overall health and most people can resume their usual activities in a few days .
RFA is most effective for tumors smaller than 5 cm in diameter .
Recent studies have shown that RFA , in certain types of cancer has improved survival compared to surgical resection in small tumors .
It us a very safe procedure , with complication rates on the order of two to three percent , and has been available since the late 1990s .
By decreasing the size of a large mass , or treating a new tumors in the liver , the pain and other debilitating symptoms caused by the tumors are revealed .
RFA is effective for small to medium – sized tumors and emerging new technologies should allow the treatment of large cancers in the future .

Why use this technique

Patients with Metastatic Cancer
Data supports that when used in conjunction with traditional chemotherapy in patients with unresectable metastatic colorectal cancer (mCRC), RFA can help to extend patient survival. (The Cancer J., 2007)

There are more than 400,000 patients with CRC worldwide:

  • 25% of patients will have metastasis in their liver at the time they are diagnosed with colorectal cancer (Ann Surg 2007)
  • Only 20% of patients with liver metastases are candidates for surgical resection (Ann Surg Oncol, 2000)
  • 46% of the patients that don’t survive mCRC will have tumors limited to the liver (Weiss, et, al 1986)

Patients with Hepatocellular Carcinoma (HCC) or Primary Liver Cancer:
In patients that have unresectable primary liver cancer (HCC) RFA is listed as a standard of care in Child Pugh A patient with unresectable lesions.(Sem Liver Dis, 1999)

RFA can also be used in conjunction with other modalities such as embolization or chemo-embolization to bridge patients to transplant or extend patient survival when transplant is not an option. (Hepatology, 2010)

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Microwave ablation is a minimally invasive surgical technique for the treatment of primary and secondary liver tumors after localizing the tumor with imaging guidance , a thin microwave antenna is placed directly into the tumors . a microwave generates electromagnetic waves that heat that induces cellular death .
Ablation can be performed without surgery or during open or minimally invasive surgery .
Microwave can be considered a safe technique for treatment of liver tumors .
Potential benefits of microwave ablation include :-
– Consistently higher intra – tumoral temperature .
– Large tumor ablation volumes .
– Faster ablation times

Why use this technique

  • Minimally invasive—usually done on an outpatient basis
  • Multiple ablations can be done as prescribed by your physician
  • Few complications or side effects

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The Nanoknife system employs irreversible electroporation – a novel new in cancer treatment technology that was a series of microsecond electrical pulses instead of extreme heat , radiation or microwave energy – to permanently open cell membranes pores are opened the death of the target cancer cell is inducted .
Surrounding veins , nerves and ducts within the targeted area are largely unaffected by the process around them , providing a compelling tool for procedures in difficult to treat parts of the body .
The destruction of veins in certain organs or parts of the body , inherent in more traditional treatments , can result in heavy and some cases potentially dangerous bleeding if not carefully managed . destructive of nerves can result in other problems that make treatment in sensitive parts of the body a challenge .

Why use this technique

  • No open incisions
  • Less damage to healthy tissue
  • Minimal postoperative pain
  • Fewer side effects
  • Short hospital stay
  • Quick post-operative recovery
  • Ability to repeat the procedure if new tumors develop

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