Minami Yasunori, Kudo Masatoshi
Department of Gastroenterology and Hepatology, School of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama 589-8511, Japan.
Int J Hepatol. 2011;2011:104685. doi: 10.4061/2011/104685. Epub 2011 May 11.
Radiofrequency ablation (RFA) of liver cancers can be performed safely using percutaneous, laparoscopic, or open surgical techniques, and much of the impetus for the use of RFA has come from cohort series that have provided an evidence base for this technique. Here, we give an overview of the current status of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC), including its physical properties, to assess the characteristics that make this technique applicable in clinical practice. We review the technical development of probe design and summarize current indications and outcomes of reported clinical use. An accurate evaluation of treatment response is very important to secure successful RFA therapy since a sufficient safety margin (at least 0.5 cm) can prevent local tumor recurrences. We also provide a profile of side effects and information on the integration of this technique into the general management of patients with HCC. To minimize complications of RFA, physicians should be familiar with each feature of complication. Appropriate management of complications is essential for successful RFA treatment. Moreover, adjuvant therapy, such as molecular targeted therapies following curative therapy, is expected to further improve survival after RFA.
肝癌的射频消融（RFA）可通过经皮、腹腔镜或开放手术技术安全进行，而使用RFA的主要动力来自队列研究系列，这些研究为该技术提供了证据基础。在此，我们概述了肝细胞癌（HCC）射频消融（RFA）的现状，包括其物理特性，以评估使该技术适用于临床实践的特征。我们回顾了探头设计的技术发展，并总结了已报道临床应用的当前适应症和结果。准确评估治疗反应对于确保RFA治疗成功非常重要，因为足够的安全 margins（至少0.5厘米）可以预防局部肿瘤复发。我们还提供了副作用概况以及关于将该技术纳入HCC患者综合管理的信息。为了尽量减少RFA的并发症，医生应熟悉并发症的每个特征。对并发症进行适当管理对于RFA治疗成功至关重要。此外，辅助治疗，如根治性治疗后的分子靶向治疗，有望进一步提高RFA后的生存率。
