Percutaneous tumor ablation with radiofrequency.
BACKGROUND
Radiofrequency thermal ablation (RFA) is a new minimally invasive treatment for localized cancer. Minimally invasive surgical options require less resources, time, recovery, and cost, and often offer reduced morbidity and mortality, compared with more invasive methods. To be useful, image-guided, minimally invasive, local treatments will have to meet those expectations without sacrificing efficacy.


METHODS
Image-guided, local cancer treatment relies on the assumption that local disease control may improve survival. Recent developments in ablative techniques are being applied to patients with inoperable, small, or solitary liver tumors, recurrent metachronous hereditary renal cell carcinoma, and neoplasms in the bone, lung, breast, and adrenal gland.


RESULTS
Recent refinements in ablation technology enable large tumor volumes to be treated with image-guided needle placement, either percutaneously, laparoscopically, or with open surgery. Local disease control potentially could result in improved survival, or enhanced operability.


CONCLUSIONS
Consensus indications in oncology are ill-defined, despite widespread proliferation of the technology. A brief review is presented of the current status of image-guided tumor ablation therapy. More rigorous scientific review, long-term follow-up, and randomized prospective trials are needed to help define the role of RFA in oncology.
Wood
Bradford J
BJ
Diagnostic Radiology Department, Special Procedures Division, National Institutes of Health Clinical Center, Bethesda, Maryland 20892, USA. bwood@nih.gov
Ramkaransingh
Jeffrey R
JR
Fojo
Tito
T
Walther
McClellan M
MM
Libutti
Stephen K
SK
D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009364:Neoplasm Recurrence, Local; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome