Current status of radio-frequency ablation for hepatocellular carcinoma

Summary BACKGROUND: Radio-frequency ablation (RFA) is the latest developed and widely practised local ablation therapy for liver tumours. It has the merit of effective tumour ablation and preservation of the maximal normal liver parenchyma. In the past few years, there has been tremendous expansion in the application of RFA for hepatocellular carcinoma (HCC) patients. However, the therapeutic effect of this local-ablation treatment needs to be balanced against its risks and possible local failure. METHODS: This review focuses on the current status of RFA for HCC, with attention to its indications, approaches, risks, local failure, and survival benefit. RESULTS: Although the results of most clinical studies of RFA seem optimistic, the associated complication and tumour recurrence should not be overlooked. Careful patient selection, meticulous RFA techniques, and prompt treatment of residual and recurrent tumours are necessary to ensure a better outcome after RFA. CONCLUSIONS: Until recently, there has been no strong evidence showing that RFA can replace any treatment modalities in the management of HCC. Nonetheless, more convincing evidence by randomised trials is required for the establishment of a treatment protocol of RFA for HCC patients.