Published online Apr 15, 2013. doi: 10.4251/wjgo.v5.i4.71
Revised: March 10, 2013
Accepted: March 15, 2013
Published online: April 15, 2013
Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be performed via an open, laparoscopic, or image guided percutaneous approach and be performed under general or local anesthesia. Advances in delivery mechanisms, electrode designs, and higher power generators have increased the maximum volume that can be ablated, while maximizing oncological outcomes. In general, RFA is used to control local tumor growth, prevent recurrence, palliate symptoms, and improve survival in a subset of patients that are not candidates for surgical resection. It’s equivalence to surgical resection has yet to be proven in large randomized control trials. Currently, the use of RFA has been well described as a primary or adjuvant treatment modality of limited but unresectable hepatocellular carcinoma, liver metastasis, especially colorectal cancer metastases, primary lung tumors, renal cell carcinoma, boney metastasis and osteoid osteomas. The role of RFA in the primary treatment of early stage breast cancer is still evolving. This review will discuss the general features of RFA and outline its role in commonly encountered solid tumors.
Core tip: We have described the technical aspects of radiofrequency ablation (RFA), advances in delivery mechanisms, indications for usage, and its equivalence or lack of equivalence to surgical resection. We emphasized studies that reported long term oncologic outcomes associated with RFA use for primary and metastatic liver and lung tumors, and described the evolving role of RFA for breast and solid renal tumors.