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World J Gastroenterol. May 28, 2014; 20(20): 5987-5998
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.5987
Value of radiofrequency ablation in the treatment of hepatocellular carcinoma
Kai Feng, Kuan-Sheng Ma
Kai Feng, Kuan-Sheng Ma, Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Author contributions: Ma KS designed the study; Feng K wrote the article.
Supported by National Natural Science Foundation of China, No. 81272688; and Foundation of State Key Laboratory of Trauma, Burn and Combined Injury, No. SKLKF201209
Correspondence to: Kuan-Sheng Ma, Professor, Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, No. 30 Gaotanyanzheng Street, Shapingbei District, Chongqing 400038, China.
Telephone: +86-23-687765813 Fax: +86-23-68765812
Received: September 12, 2013
Revised: February 21, 2014
Accepted: April 1, 2014
Published online: May 28, 2014

Hepatocellular carcinoma (HCC) is a malignant disease that substantially affects public health worldwide. It is especially prevalent in east Asia and sub-Saharan Africa, where the main etiology is the endemic status of chronic hepatitis B. Effective treatments with curative intent for early HCC include liver transplantation, liver resection (LR), and radiofrequency ablation (RFA). RFA has become the most widely used local thermal ablation method in recent years because of its technical ease, safety, satisfactory local tumor control, and minimally invasive nature. This technique has also emerged as an important treatment strategy for HCC in recent years. RFA, liver transplantation, and hepatectomy can be complementary to one another in the treatment of HCC, and the outcome benefits have been demonstrated by numerous clinical studies. As a pretransplantation bridge therapy, RFA extends the average waiting time without increasing the risk of dropout or death. In contrast to LR, RFA causes almost no intra-abdominal adhesion, thus producing favorable conditions for subsequent liver transplantation. Many studies have demonstrated mutual interactions between RFA and hepatectomy, effectively expanding the operative indications for patients with HCC and enhancing the efficacy of these approaches. However, treated tumor tissue remains within the body after RFA, and residual tumors or satellite nodules can limit the effectiveness of this treatment. Therefore, future research should focus on this issue.

Keywords: Hepatocellular carcinoma, Radiofrequency ablation, Liver transplantation, Hepatectomy, Hepatitis B

Core tip: The pivotal role of radiofrequency ablation (RFA) has recently been established among the various treatment strategies for hepatocellular carcinoma (HCC), primarily due to its excellent local tumor control. RFA may be complementary to the other treatments with curative intent for HCC and its beneficial outcomes in patients have been demonstrated in several clinical studies.