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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Radiofrequency ablation of liver tumors (I): biological background

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Department of Surgery, Kaunas University of Medicine
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Institute for Biomedical Research, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2010, 46(1), 13; https://doi.org/10.3390/medicina46010002
Received: 30 September 2008 / Accepted: 4 January 2010 / Published: 9 January 2010
Majority of patients suffering from liver tumors are not candidates for surgery. Currently, minimal invasive techniques have become available for local destruction of hepatic tumors. Radiofrequency ablation is based on biological response to tissue hyperthermia. The aim of this article is to review available biological data on tissue destruction mechanisms. Experimental evidence shows that tissue injury following thermal ablation occurs in two distinct phases. The initial phase is direct injury, which is determined by energy applied, tumor biology, and tumor microenvironment. The temperature varies along the ablation zone and this is reflected by different morphological changes in affected tissues. The local hyperthermia alters metabolism, exacerbates tissue hypoxia, and increases thermosensitivity. The second phase – indirect injury – is observed after the cessation of heat stimulus. This phase represents a balance of several promoting and inhibiting mechanisms, such as induction of apoptosis, heat shock proteins, Kupffer cell activation, stimulation of the immune response, release of cytokines, and ischemia-reperfusion injury. A deeper understanding of the underlying mechanisms may possibly lead to refinements in radiofrequency ablation technology, resulting in advanced local tumor control and prolonged overall survival.
Keywords: radiofrequency ablation; liver tumor; thermal injury radiofrequency ablation; liver tumor; thermal injury
MDPI and ACS Style

Vanagas, T.; Gulbinas, A.; Pundzius, J.; Barauskas, G. Radiofrequency ablation of liver tumors (I): biological background. Medicina 2010, 46, 13.

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