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Radiofrequency Ablation

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.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

What works? Research summarized

Evidence reviews

Should radiofrequency ablation be used in patients with liver colorectal metastases? 

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 During the past decade radiofrequency ablation has superseded other ablative therapies, due to its low morbidity, mortality, safety and patient acceptability.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.

Radiofrequency ablation for the treatment of liver cancer (hepatocellular carcinoma)

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).

Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for varicose veins

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.

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Summaries for consumers

Should radiofrequency ablation be used in patients with liver colorectal metastases? 

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.

Radiofrequency ablation for the treatment of liver cancer (hepatocellular carcinoma)

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).

Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for varicose veins

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.

See all (29)

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