Birth M, Hildebrand P, Dahmen G, Ziegler A, Bröring D C, Hillert C, Bruch H P
Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
Chirurg. 2004 Apr;75(4):417-23. doi: 10.1007/s00104-003-0801-9.
Radio frequency ablation (RFA) represents a new technique for local destruction of liver tumors. Indication and procedure are poorly validated at present.
To record the actual nationwide RFA application in Germany, a survey of 2026 hospitals with standardized questionnaires was conducted.
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.
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.
射频消融（RFA）是一种用于局部破坏肝脏肿瘤的新技术。目前，其适应症和操作方法尚未得到充分验证。
为记录德国全国范围内RFA的实际应用情况，采用标准化问卷对2026家医院进行了调查。
回复率为17.5%，对来自58家医院的1700例接受消融治疗的患者的结果进行了分析。其中，25.9%的医院已将RFA用于潜在可治愈的可切除肿瘤，22.4%的医院甚至在预期通过不完全消融来缩小肿瘤体积时也使用RFA。在这58家医院中，75%将切除术和RFA联合使用以达到所谓的R-0状态。他们提到的实现完全消融的最大肿瘤大小范围从<3厘米到11厘米。在RFA的禁忌症中，肿瘤大小、肿瘤数量、肿瘤的关键位置以及肝功能障碍被提及得最多。
本次调查表明，肝脏肿瘤RFA在适应症、应用、操作方法和结果方面存在显著差异。缺乏通用标准以及对该方法的高估可能导致不加批判地应用、忽视标准治疗或结果不尽人意。
