Current oncologic applications of radiofrequency ablation therapies

Shah, Dhvanit I.; Green, Sari; Elliot, Angelina; McGahan, John P.; Khatri, Vijay P.

doi:10.4251/wjgo.v5.i4.71

Cited by 70 publications

(54 citation statements)

References 66 publications

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“…Radiofrequency ablation (RFA) has been increasingly accepted as a potentially promising nephron‐sparing, minimally invasive therapeutic option for patients with small localized renal masses. In addition, RFA as a primary or adjuvant treatment modality has been widely used in solid tumors such as hepatocellular carcinoma, lung cancer, breast cancer, and RCC [7]. In 1997, Zlotta et al [8] reported the first clinical use of renal RFA for the treatment of localized renal masses.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta‐analysis

Pan

Cui

Huang

et al. 2015

The Kaohsiung J of Med Scie

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Our study was to collect the data available in the literature on radiofrequency ablation (RFA) and partial nephrectomy (PN) and conduct a cumulative analysis on perioperative outcomes, renal function outcomes, and survival to evaluate the overall safety and efficacy of RFA versus PN for small renal cell cancer (SRCC). A literature search was carried out using various electronic databases. Data including age, tumor size, comorbid disease, operation duration, hospital stay, pre- and postoperative estimated glomerular filtration rate (eGFR), major and minor complications, and local tumor recurrence and metastasis were collected for meta-analysis. Sixteen studies were included for this meta-analysis. The age of patients treated with RFA was significantly older than that of patients treated with PN [weighted mean difference (WMD) = 5.07 years]. There were more patients with cardiovascular disease in RFA group as compared with PN group [odds ratio (OR) = 4.24] before treatment. RFA was associated with a shorter length of hospital stay compared with PN (WMD = -2.02 days). No significant difference was found in major and minor complications between the two groups (major: OR = 0.74; minor: OR = 0.45). Preoperative eGFR and eGFR decline in RFA patients was significantly lower than that in PN patients (WMD = -7.27 and -4.82, respectively), whereas there was no significant difference in postoperative eGFR (WMD = -1.18). The local tumor recurrence rate in RFA group was higher than that in PN group (OR = 1.81). However, the distant metastasis rate was no statistical difference between the two groups (OR = 1.63). RFA is a suitable therapeutic option for older patients and those at high risk for SRCC because of a low risk of operation and better preservation of renal function.

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Section: Introductionmentioning

confidence: 99%

Radiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta‐analysis

Pan

Cui

Huang

et al. 2015

The Kaohsiung J of Med Scie

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“…In this context, minimal or non‐invasive ablation could offer an interesting option for tumor treatment, in order to avoid the risk of complications related to surgery and to optimize the cosmetic outcome, reducing patient discomfort. Furthermore, ablative treatments could be used to control local tumor growth, palliate symptoms, and improve survival in patients with poor health who are not candidates for surgical resection …”

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confidence: 99%

MRI‐guided treatment in the breast

Pediconi

Marzocca

Marincola

et al. 2018

Magnetic Resonance Imaging

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In the last decades, an increasing interest has developed towards non‐invasive breast lesion treatments, which offer advantages such as the lack of surgery‐related complications, better cosmetic outcomes, and less psychological distress. In addition, these treatments could be an option for patients with poor health who are not candidates for surgery. Non‐surgical ablation can be performed under magnetic resonance (MR) or ultrasound (US) guidance. US is cheaper and easily available, while contrast‐enhanced MR is more accurate, ensuring better safety and efficacy for the patient. Overall results of studies about MRI‐guided tumor ablation reported complete ablation rates ranging between 20% and 100%. High‐intensity focused ultrasound (HIFU or FUS) is the most studied ablative technique and it is already established as a valid technique for ablation of benign and malignant tumors in various organs. Ultrasound‐guided FUS is very useful for young patients who refuse surgery or with multiple nodules; however, MR‐guided FUS is more sensitive and allows a better evaluation of thermal accumulation within the ablated tissue or the adjacent structures. Most MR‐guided FUS studies used a dedicated high‐field MR scanner and complete tumor ablation was reported in 17–90% of cases. Other techniques using thermal tissue destruction are radiofrequency ablation (RFA) and laser interstitial thermal therapy (LITT). Only a few studies assessed the efficacy of these treatments, all were performed with open MR devices. RFA showed complete tumor ablation in 30–96% of patients, while LITT in 10–71%, but all the studies had a small number of patients. Cryoablation obtains tissue ablation by a rapid decrease of temperature, with a complete tumor removal reported in 18–52% of cases with MR guidance. No serious complications were reported with these techniques. Currently, breast conservative surgery replaced radical surgery when possible. Therefore, future research should focus on these treatments to shift towards an even less invasive approach to breast neoplasms. Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:1479–1488

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“…However, it has yet to be proven equivalent to surgical resection in randomized control trials since studies comparing the two treatments for resectable disease have yet to be performed [57]. Patients who undergo RFA alone for metastatic lesions immediately adjacent to a hepatic vein have higher incidences of intrahepatic recurrence due to the well-documented ''heat-sink'' effect.…”

Section: Alternative Therapies To Surgerymentioning

confidence: 96%

Role of imaging for patients with colorectal hepatic metastases: what the radiologist needs to know

et al. 2015

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Surgical resection of colorectal metastatic disease has increased as surgeons have adopted a more aggressive ideology. Current exclusion criteria are patients for whom a negative resection margin is not feasible or a future liver remnant (FLR) of greater than 20% is not achievable. The goal of preoperative imaging is to identify the number and distribution of liver metastases, in addition to establishing their relation to relevant intrahepatic structures. FLR can be calculated utilizing cross-sectional imaging to select out patients at risk for hepatic dysfunction after resection. MRI, specifically with gadoxetic acid contrast, is currently the preferred modality for assessment of hepatic involvement for patients with newly diagnosed colorectal cancer, to include those who have undergone neoadjuvant chemotherapy. Employment of liver-directed therapies has recently expanded and they may provide an alternative to hepatectomy in order to obtain locoregional control in poor surgical candidates or convert patients with initially unresectable disease into surgical candidates.

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Current oncologic applications of radiofrequency ablation therapies

Cited by 70 publications

References 66 publications

Radiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta‐analysis

Radiofrequency ablation versus partial nephrectomy for treatment of renal masses: A systematic review and meta‐analysis

MRI‐guided treatment in the breast

Role of imaging for patients with colorectal hepatic metastases: what the radiologist needs to know

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