Review
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World J Gastrointest Oncol. Apr 15, 2013; 5(4): 71-80
Published online Apr 15, 2013. doi: 10.4251/wjgo.v5.i4.71
Current oncologic applications of radiofrequency ablation therapies
Dhruvil R Shah, Sari Green, Angelina Elliot, John P McGahan, Vijay P Khatri
Dhruvil R Shah, Angelina Elliot, Vijay P Khatri, Division of Surgical Oncology, Department of Surgery, University of California Davis, Sacramento, CA 95815, United States
Sari Green, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA 90502, United States
John P McGahan, Department of Radiology, University of California Davis, Sacramento, CA 95815, United States
Author contributions: Shah DR analyzed the data and wrote the paper; Green S performed the background research and created a portion of the tables for the paper; Elliot A performed the background research and created a portion of the tables for the paper; McGahan JP critically reviewed the manuscript; Khatri VP designed the research and critically revised it.
Correspondence to: Vijay P Khatri, MBChB, FACS, Professor of Surgery, Division of Surgical Oncology, Department of Surgery, University of California, 4501 X Street, Sacramento, CA 95817, United States. vijay.khatri@ucdmc.ucdavis.edu
Telephone: +1-916-7342172 Fax: +1-916-7035267
Received: February 1, 2013
Revised: March 10, 2013
Accepted: March 15, 2013
Published online: April 15, 2013
Processing time: 90 Days and 5.8 Hours
Abstract

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.

Keywords: Radiofrequency ablation; Hepatocellular carcinoma; Colorectal cancer liver metastasis; Lung cancer; Renal cell carcinoma

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.