Hepatic resection but not radiofrequency ablation results in tumor growth and increased growth factor expression

OBJECTIVE: The purpose of this study was to examine the effects of radiofrequency ablation (RFA) on tumor growth and growth factor expression in a murine model. BACKGROUND: Surgical excision remains the only potentially curative therapy for hepatic malignancies. Tumor growth in the remaining liver may be accelerated after resection. The mechanism of this enhanced tumor growth remains unexplained, although growth factors that are released after hepatic resection (which facilitate liver regeneration) may play a role in residual tumor growth. RFA has become a viable alternative for patients who are not candidates for a curative resection. The effect of RFA on tumor growth and growth factor expression has not been studied. METHODS: Hepatic tumors were established by direct injection with CT-26, a murine adenocarcinoma. Tumors were treated by either partial hepatic resection (PH) or RFA. Hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) expression was measured at selected time intervals post-treatment. Tumor growth was measured by reinjection of CT-26 into the residual liver after treatment. Nine days after reinjection, tumor volume was calculated and compared with nontreated controls. RESULTS: HGF and bFGF expression was significantly higher at baseline in the CT-26 tumor-bearing mice when compared with non-tumor-bearing controls (P = 0.00001 and P = 9 × 10, respectively). There was an increase in HGF and bFGF expression at 24 hours (P = 0.005, and P = 0.001) in the PH group. In the RFA group, there was a decrease in HGF and bFGF expression at 24 and 72 hours (P = 0.001 and P = 0.002). Tumor growth comparisons revealed an increase in tumor growth in the hepatectomy group (P = 0.006) but not the RFA group (P = 0.2). CONCLUSIONS: Baseline growth factor expression in tumor-bearing mice is exponentially higher when compared with non-tumor-bearing controls. HGF and bFGF expression are increased posthepatectomy, and decreased post-RFA. Partial hepatectomy results in an increase in tumor growth in the residual liver. RFA did not increase tumor growth after treatment. While hepatectomy is the only curative option for patients with hepatic malignancies, it may accelerate growth of microscopic residual disease.