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A procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity). Radiofrequency ablation may be used to treat cancer and other conditions.

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Colorectal cancer is one of the most common malignant tumour worldwide and approximately 50 % of patients will develop liver metastases (liver is the first site of metastatic disease). Hepatic resection is the only curative option, but only 15‐20% of patients with liver metastases from colorectal cancer are suitable for surgical standard treatment. Besides chemotherapy, several minimally invasive treatment techniques have been developed to treat patients with CRLMs: hepatic arterial infusion, cryotherapy, microwave ablation, selective internal radion treatment, radiofrequency ablation. During the past decade radiofrequency ablation has superseded other ablative therapies, due to its low morbidity, mortality, safety and patient acceptability. Radiofrequency ablation is a minimally invasive technique in which a needle is inserted into the tumour (liver metastases) either getting access by way of the skin (percutaneously) or via open approach (surgically). Alternating current is generated using radio waves and, through needle, create local tissue temperatures of 50‐100˚C temperature, that causes “coagulation” and tumour necrosis. According to several studies RFA is technically feasible and safe for the treatment of CRLMs, however little is known about its efficacy in terms of overall survival (OS), disease free survival (DFS) and local recurrence. The aim of this review was to see if the treatment of CRLMs with RFA provides more benefit in terms of overall survival, disease free survival and local recurrence. This review include 18 studies (10 observational studies, 7 CCTs and an additional 1 RCT) comparing radiofrequency ablation with any other treatment. The heterogeneity regarding interventions, comparisons and outcomes rendered the data unusable and unsuitable for drawing conclusions. There is insufficient evidence to recommend the use of radiofrequency ablation for a radical treatment of liver metastases from colorectal cancer. High quality randomised clinical trials are required to answer on the potential benefit and harms associated with the use of radiofrequency ablation in the treatment of liver metastases from colorectal cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 13, 2012

Varicose veins (varices) are enlarged veins occurring below the skin's surface, usually in the legs. One‐third of the UK population may be affected. They can be painful and itchy, the surrounding skin may change colour, and occasionally they may bleed; in some people, untreated varicose veins may lead to ulceration. Varicose veins occur due to leaky valves within the veins. Traditionally, they were treated with surgery to remove the veins. Newer techniques require neither vein removal, nor a general anaesthetic; they may involve less pain after the procedure and have a lower risk of complications, resulting in quicker recovery and return to normal activities. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are methods that seal the main leaking vein. They are performed using a local anaesthetic; a probe is passed into the vein: either a tiny laser or radiofrequency makes the wall of the vein heat up causing the vein to clot off and seal. With ultrasound‐guided foam sclerotherapy (UGFS), a foam is injected into the veins; the foam pushes the blood away, causing thickening and scarring of the inside of the vein so that it becomes blocked.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 29, 2016

Liver cancer (hepatocellular carcinoma) is the fifth most common cancer worldwide. In the majority of patients, hepatocellular carcinoma is diagnosed at advanced stages of the disease and is mostly accompanied by liver cirrhosis. To date, there is no medical cure for patients with hepatocellular carcinoma, and treatment aims to slow tumour growth. In high‐income countries, about 30% of patients present with the more favourable early hepatocellular carcinoma. For these patients, percutaneous ablation techniques (destruction of the cancer cells by heat, cold, or chemical substances such as ethanol), surgical resection (removal of part of the liver), and liver transplantation (which is limited by organ donor shortage) are currently considered potentially curative treatments. Radiofrequency (thermal) ablation (RFA) is the most elaborated of the percutaneous interventions, so far. Heat caused by alternating electric current is administered by probes that are inserted through the skin (percutaneously).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 19, 2013

Varicose veins are dilated, tortuous superficial veins. When they are in the legs they can be painful, itchy or unsightly, especially when patients are standing and walking. Varicose veins are conventionally treated with surgery to remove the veins, by stripping them to the level of the knee (so‐called high ligation and stripping). New less invasive treatments seal the main leaking vein in the thigh using foam sclerotherapy, laser (endovenous laser therapy) or radiofrequency ablation. These techniques may result in less pain after the procedure, fewer complications, and a quicker return to work and normal activities with improved patient quality of life, as well as avoiding the need for a general anaesthetic.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 30, 2014

Bibliographic details: Piper M A, Seidenfeld J, Aronson N.  Radiofrequency ablation of unresectable hepatic tumors. Chicago, IL, USA: Blue Cross and Blue Shield Association, Technology Evaluation Center. TEC Assessment Program; 18(13). 2003

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Bibliographic details: Sun B, Zheng CS, Feng GS, Wang Y, Xia XW, Kan XF.  [Radiofrequency ablation versus surgical resection for small hepatocellular carcinoma: a meta-analysis]. World Chinese Journal of Digestology 2011; 19(31): 3255-3263

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Bibliographic details: Andrade JG, Dubuc M, Rivard L, Guerra PG, Mondesert B, MacLe L, Thibault B, Talajic M, Roy D, Khairy P.  Efficacy and safety of atrial fibrillation ablation with phased radiofrequency energy and multielectrode catheters. Heart Rhythm 2012; 9(2): 289-29621907169

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Bibliographic details: Deng LB, Li XG, Ming WD.  Radiofrequency ablation for the treatment of advanced non-small-cell lung cancer: a meta-analysis. Journal of Interventional Radiology 2013; 22(12): 1000-1006

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Bibliographic details: Zhao S, Chen XC, Long QY, Zhang XL.  [Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma: a systematic review and meta analysis]. Journal of Interventional Radiology 2013; 22(11): 908-913 Available from: http://dx.doi.org/10.3969/j.issn.1008-794X.2013.11.008

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Bibliographic details: Han X, Lv WF.  [Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma: a meta-analysis of long-term efficacy]. Journal of Interventional Radiology 2013; 22(5): 387-391 Available from: http://dx.doi.org/10.3969/j.issn.1008-794X.2013.05.009

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Bibliographic details: Medical Advisory Secretariat.  Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis. Toronto, ON, Canada: Ontario Ministry of Health and Long Term Care. Ontario Health Technology Assessment Series; 11(1). 2011 Available from: http://www.health.gov.on.ca/english/providers/program/mas/tech/ohtas/tech_rfa_vv_20110216.html

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Bibliographic details: Alvarez C B, Fernandez J M, Magro de la Plaza A, Bustos F A, Calvo A G, Vicent J G, Blanco J M.  [Efficacy and safety of radiofrequency ablation of malignant liver tumours: a systematic review]. [Ablacion por radiofrecuencia del carcinoma hepatocelular y otros tumores hepaticos: revision sistematica sobre la eficacia, seguridad y relacion coste-efectividad.] Madrid, Spain: Agencia de Evaluacion de Tecnologias Sanitarias. Informe de Evaluacion de Tecnologias Sanitarias; 43. 2004

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Bibliographic details: Ni JY, Sun HL, Luo JH, Wang WD, Chen YT, Xu LF.  Meta-analysis of randomized controlled trials: percutaneous radiofrequency ablation in the treatment of hepatocullular carcinoma. Chinese Journal of Cancer Prevention and Treatment 2014; 21(9): 711-717 Available from: http://eng.oversea.cnki.net/kcms/detail/detail.aspx?dbCode=cjfd&QueryID=13&CurRec=20&filename=QLZL201409020&dbname=CJFDLAST2014

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

This guideline covers the assessment and management of low back pain and sciatica in adults over the age of 16 years.

NICE Guideline - National Guideline Centre (UK).

Version: November 2016

This report evaluates the current state of evidence regarding effectiveness and harms of catheter ablation for atrial fibrillation (AF) with a focus on longer-term outcomes and evidence relevant to the Medicare population.

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: April 20, 2015

Atrial fibrillation (AF) is a very common problem. In England alone, approximately 835,000 people have AF.321 Through its effects on rate and rhythm, it is a major cause of morbidity. Through increasing susceptibility to stroke, it is a major cause of both morbidity and mortality.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: June 2014

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate (tachycardia). A normal heart rate should be regular and between 60 and 100 beats a minute when resting. In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute. This can cause symptoms such as dizziness, shortness of breath, and tiredness that affect quality of life, but more importantly, atrial fibrillation increases the risk of suffering a stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 22, 2016

BACKGROUND/AIMS: To investigate the meta-analysis of the effect between radiofrequency ablation (RFA) and cryosurgery ablation (CSA) in treating unresectable hepatocellular carcinoma (HCC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Heavy menstrual bleeding (HMB) is a common problem that affects approximately 1.5 million women in England and Wales and accounts for 20% of gynaecology outpatient referrals. Although objectively defined as cyclical loss of > 80 ml of blood during each menstrual period, HMB is diagnosed clinically in the presence of excessive menstrual blood loss that interferes with a woman's physical, emotional, social and material quality of life.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2011

Varicose veins are enlarged tortuous superficial veins at least 3mm in diameter that usually affect the great (GSV) and small (SSV) saphenous veins in the lower limbs. Varicose veins are caused by decreased elasticity of the vein wall and poorly functioning valves within the vein, resulting in blood pooling in the veins and vein enlargement. The symptoms of varicose veins can range in severity from occasional discomfort to severe ulceration of the skin. Approximately 10 to 40% of Western populations have varicose veins, and varicosities can cause considerable disability, resulting in decreased quality of life and loss of work days. If left untreated, varicose veins can progress to chronic venous insufficiency, which increases the likelihood of tissue damage and development of venous stasis ulcers.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: August 19, 2014

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