Usefulness of radiofrequency ablation of liver tumors

Author's objectives The aim of this review was to assess the efficacy and safety of radiofrequency ablation (RFA) of liver tumors. Author's conclusions Most malignant liver tumors can not be surgically removed because of their extension, systemic involvement, comorbidities or tumor size. RFA is proposed as an alternative for patients with primary hepatocellular tumors or liver metastases of colorectal cancer, when surgery is not possible. When assessing the evidence, it is observed that in all cases tumor resection is the treatment of choice. When this is not possible, RFA shows more effectiveness than most alternative treatments. However, it is worth mentioning that the differences found are mainly in the rates of local recurrence and length of hospital stay, but there are no differences in survival. In addition, complications, although not evaluated by many authors, would be fewer than in other treatment alternatives (experts suggest a complication rate of 3% to 5%), with a mortality rate lower than 1%. To use this treatment, it is recommended that a multidisciplinary team including a liver surgeon performs a patient selection and that it is performed under ultrasound or topography guidance. The requirements that must be met to use RFA in patients with liver tumor are: - not candidates for surgical tumor resection (either because there is local involvement, or because of tumor location or comorbidities) - metastases of an isolated colorectal cancer or a hepatocarcinoma - no systemic or extrahepatic disease - identification images (ultrasound or computed tomography) - tumors less than 4 cm in diameter. Those tumors of other origins which are treated with RFA or which are treated for palliative treatment are considered investigational. Structured abstract from Health Technology Assessment Database