[Present state of radio frequency ablation of liver tumors in Germany].
BACKGROUND
Radio frequency ablation (RFA) represents a new technique for local destruction of liver tumors. Indication and procedure are poorly validated at present.


METHODS
To record the actual nationwide RFA application in Germany, a survey of 2026 hospitals with standardized questionnaires was conducted.


RESULTS
With a respond rate of 17.5%, results from 58 hospitals covering 1700 ablated patients were analyzed. In 25.9% of them, RFA is already used in potentially curative resectable tumors, in 22.4% even when incomplete ablation for tumor mass reduction is expected. Of the 58 hospitals, 75% combine resection and RFA to reach a so-called R-0 situation. The maximal tumor sizes they quoted for achieving complete ablation ranged from <3 cm to 11 cm. In contraindications for RFA, the tumor size, number of tumors, critical localization of the tumor, and disorders of liver function were mentioned the most.


CONCLUSIONS
This survey documents significant discrepancies in indication, application, procedure, and results in RFA for liver tumors. The lack of general standards and an overestimation of the method may lead to uncritical application, neglect of standard therapy, or unsatisfying results.
Birth
M
M
Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
Hildebrand
P
P
Dahmen
G
G
Ziegler
A
A
Bröring
D C
DC
Hillert
C
C
Bruch
H P
HP
D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D000075202:Contraindications; D003952:Diagnostic Imaging; D005858:Germany; D006801:Humans; D006979:Hyperthermia, Induced / Q000706:statistics & numerical data*; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D015203:Reproducibility of Results; D013673:Technology Assessment, Biomedical