Radiofrequency thermal ablation of abdominal tumors: lessons learned from complications

Radiofrequency (RF) thermal ablation has shown promise as a technique for treating inoperable solid tumors involving the liver, kidney, adrenal gland, and lung. However, like all other imaging-guided interventional procedures, RF ablation involves some element of risk. Varying degrees of complications can be expected, depending on factors such as the organ site and the aggressiveness of the procedure. General complications of RF ablation may be related to either imaging-guided electrode placement (eg, bleeding, infection, tumor seeding, pneumothorax) or thermal therapy (eg, nontarget thermal damage, grounding pad burns). Liver and renal-adrenal ablation may be associated with organ-specific complications. A fundamental understanding of RF ablation principles, along with adequate operator training and experience and familiarity with both thermal ablation and the broad spectrum of postablation complications, are necessary to maximize the safety and efficacy of this procedure. The standard of care for decreasing the morbidity of complications consists of prevention (including careful patient selection), early detection, and prompt, appropriate treatment.