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Percutaneous radiofrequency ablation of liver metastases: Applications and potential indications

Perkutane Radiofrequenzablation von Lebertumoren: Applikationen und potentielle Indikationen

  • Main Topics: Current Strategies In The Treatment Of Colorectal Cancer Liver Metastases
  • Published:
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Summary

Background: Percutaneous liver tumour ablation has received increased attention as an effective treatment and has been published by a large number of groups. A minimally invasive, percutaneous approach requires fewer resources, less time, recovery and cost, and often offers reduced morbidity and mortality compared with more invasive methods. To be beneficial, however, image-guided percutaneous radiofrequency (RF) therapy will have to meet those criteria without sacrificing efficacy.

Methods: Image-guided, local liver tumour 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 and recurrent metachronous liver tumours.

Results: RF ablation of liver tumours with image-guided needle placement, either percutaneously, laparoscopically, or with open surgery, has proven to be effective and encouraging results have been reported. Both intraoperative and percutaneous techniques, however, are complementary options to successfully treat patients with liver tumours.

Conclusions: In this article, the authors review the technical developments and current status of liver tumour ablation using radiofrequency ablation techniques, and conclude with a discussion of challenges and opportunities for the future.

Zusammenfassung

Grundlagen: Die perkutane Zerstörung von Lebertumoren findet als effektives Verfahren zur Tumortherapie zunehmendes Interesse und wurde von zahlreichen Arbeitsgruppen publiziert. Der minimal invasive perkutane Zugang erfordert einen geringeren Aufwand an Zeit, Kosten oder Rehabilitation und weist im Vergleich mit invasiveren Verfahren eine oft geringere Morbidität und Mortalität auf. Die bildgestützte, perkutane Radiofrequenzablation hat diese Kriterien, jedoch ohne an Effektivität einzubüßen.

Methodik: Die Anwendung bildgestützter Verfahren zur lokalen Tumortherapie geht davon aus, daß eine lokale Tumorkontrolle das Überleben verlängert. Neuartige Entwicklungen auf dem Gebiet der Thermoablation ermöglichen die Zerstörung von inoperablen, kleinen oder solitären, aber auch von rezidivierenden metachronen Lebertumoren.

Ergebnisse: Die Radiofrequenzablation von Lebertumoren mit bildgestützter Plazierung der Therapiesonden kann entweder perkutan, laparoskopisch oder intraoperativ durchgeführt werden. Deren Anwendung und Wirksamkeit ist durch klinische Studien belegt. Die intraoperative und perkutane Anwendung ergänzen sich dabei in der erfolgreichen Behandlung von Lebertumoren.

Schlußfolgerungen: Technische Entwicklungen und der derzeitige Stand der Anwendung der Radiofrequenzablation von Lebertumoren werden beschrieben. Zusammenfassend werden Indikationen für die klinische Anwendung diskutiert.

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Authors and Affiliations

  1. Division of Angiography and Interventional Radiology, Department of Radiology, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna

    J. Kettenbach M.D. & F. Wolf

  2. Department of Traumatology, Wilhelminenspital, Vienna

    Martina Weigner

  3. Department of Radiology, University of Vienna, Austria

    G. Lechner

  4. Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    S. N. Goldberg

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Kettenbach, J., Wolf, F., Weigner, M. et al. Percutaneous radiofrequency ablation of liver metastases: Applications and potential indications. Eur. Surg. 34, 326–331 (2002). https://doi.org/10.1046/j.1563-2563.2002.02077.x

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