Radiofrequency ablation as an alternate therapy option in metastatic skin cancer; more research needed?

The authors reviewed pros and cons of radiofrequency ablation (RFA) in treatment of skin cancer that has spread to other parts of the body (metastatic melanoma). 

RFA is a technique that selectively removes or destroys (ablates) damaged tissues using the heat generated by high frequency current. RFA offers an alternate treatment option in metastatic melanoma for those patients who are unsuitable for  surgical removal of metastatic tumors due to a variety of reasons. However, the technique is mostly useful for smaller sized tumors.

The authors reviewed published reports related to application of RFA in treatment of melanoma that had spread to three different organs: liver, lungs and adrenal glands (these sit on top of the kidneys and produce a variety of hormones).

In one case study of 8 patients suffering from eye (ocular) melanoma that spread into liver, the survival rate was 46 months for those who opted for surgery with or without RFA, with an average overall survival rate of 36 months. In another study, 447 patients with liver tumors unsuitable for surgery were treated with RFA. Of 447 patients, 8.5% had metastatic melanoma at the start of the study. In 10.9% of the 447 patients, there was local recurrence (return of cancer close to the original site) after RFA treatment.

In one of the case-reports on management of melanoma that had spread to the lung, one patient with 4 cm lung tumor was successfully treated with RFA through the skin under local anesthesia. In another separate series of reports, one 60 year old female with three lung tumors was treated with RFA. The disease free survival was 13 months and overall survival was 14 months. In another case, a 55 year old male with lung tumors originated from ocular melanoma was treated with RFA along with surgery for two other liver metastases.  The survival was 55 months from the time of surgery.

Very limited data are available on RFA of adrenal metastases. In one study, 12 patients with 13 adrenal tumors were treated with RFA, out of which two were metastatic. After a single RFA session, 11 of the 13 tumors were successfully treated where as the remaining 2 had residual injury. However, all the patients showed steady progression of disease on subsequent follow-ups.

More patient data are needed to accurately establish the benefit, effectiveness and drawbacks of RFA therapy in treatment of metastatic melanoma.

The RFA method is limited by technical complexity and lack of adequate data.

Discuss the potential of RFA surgery with your doctor if surgery is not an option in your case.