Percutaneous tumor ablation, radiologists' non-surgical weapon against cancer

Suffering from a primary liver tumor, with a lesion on the right lobe and another on the left, Sophie (name has been changed), who also had a medical contraindication, could not benefit from surgery. However, his lesions were destroyed.

This woman from Var benefited, at the end of May, from the first percutaneous tumor ablation performed by the teams of the interventional radiology department of the Toulon La Seyne-sur-Mer Intercommunal Hospital Center.

Dr. Geoffrey Rico, interventional radiologist, and Professor Serge Agostini, head of the Imaging Department at Sainte Musse Hospital, provide an update on this minimally invasive technique that complements the therapeutic arsenal against cancers... But not only that!

By heat or by cold

"This treatment allows for the targeted destruction of lung, liver, kidney and bone tumors, without surgery. Scanner-guided needles are inserted directly into the tumor. Its destruction is achieved either by heat – radiofrequency or microwaves – or by cold – cryotherapy –, depending on the type of lesion," summarizes Dr. Rico.

This procedure, performed under general anesthesia, offers a non-invasive alternative to traditional treatments, reducing risks and speeding up recovery.

"It allows for a quick return home after a one- or two-night hospital stay. The postoperative period is easier, there is less pain, and healing is extremely rapid. There are no stitches, just the trace of an injection," confirms Dr. Rico.

An additional option

Percutaneous tumor ablation expands the scope of cancer treatment.

The case of the first Toulon patient operated on at Sainte Musse is exemplary: "We cannot operate on bifocal liver cancer. We can surgically remove the right lobe or the left lobe, not both. Percutaneous tumor ablation was the only option to destroy these two lesions," explains Professor Agostini.

This treatment is also particularly suitable for patients for whom surgery is contraindicated or presents risks, such as an elderly patient with comorbidities.

However, it is conditioned, among other things, by the size of the tumor: "Percutaneous ablation allows the destruction of small tumors, up to four or five centimeters maximum for the kidney, three centimeters for a primary lung cancer," says Dr. Rico.

An appeal decided on a case-by-case basis

The use of this process is therefore retained following validation by several professionals in a multidisciplinary consultation meeting (RCP).

The decision takes into account the patient's profile, the type of cancer and its stage.

"For example, we can destroy metastases from colorectal cancer if they are not too numerous, but also on the condition that the primary cancer is controlled by chemotherapy," explains the radiologist.

While surgery remains the gold standard treatment for kidney and lung tumors, percutaneous ablation represents "an equally effective curative alternative," emphasizes Professor Agostini. " It is a treatment in its own right that has its place in the cancer treatment toolbox," alongside surgery, radiotherapy, chemotherapy, and immunotherapy.

And that's not all: "Non-oncological indications are also emerging for percutaneous ablation, such as the destruction of endometriosis nodules or benign bone tumors."