Clinical outcomes and tumor microenvironment response to radiofrequency ablation therapy: a systematic review and meta-analysis.

Autor:	Mueller LE; School of Medicine, Tulane University, New Orleans, Louisiana, USA., Issa PP; School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA., Hussein MH; Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA., Elshazli RM; Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy, Horus University-Egypt, New Damietta, Egypt., Haidari M; School of Medicine, Tulane University, New Orleans, Louisiana, USA., Errami Y; Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA., Shama M; Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA., Fawzy MS; Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.; Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia., Kandil E; Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA., Toraih E; Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, USA.; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Jazyk:	angličtina
Zdroj:	Gland surgery [Gland Surg] 2024 Jan 29; Vol. 13 (1), pp. 4-18. Date of Electronic Publication: 2023 Jul 24.
DOI:	10.21037/gs-22-555
Abstrakt:	Background: Radiofrequency ablation (RFA) utilizes minimally invasive high-energy current to precisely ablate tumor cells. It has been utilized in many cancer types including thyroid, lung, and liver cancer. It has been shown to provide adequate ablative margins with minimal complications; however, incomplete RFA may lead to recurrence of tumor. The underlying cellular mechanism and behavior of ablated cancer tissue is poorly understood. Methods: A systematic review was performed, searching EMBASE, Web of Science, PubMed, and Scopus for studies published up to March 2022 and reported following PRISMA guidelines. Collection was performed by two groups of investigators to avoid risk of bias. The Cochrane Collaboration's tool was used for assessing risk of bias. We identified human, in vivo , and in vitro research studies utilizing RFA for tumor tissues. We required that the studies included at least one of the following: complications, recurrence, or survival, and took interest to studies identifying cellular signaling pathway patterns after RFA. Descriptive statistical analysis was performed in 'R' software including mean and confidence interval. Results: The most frequent cancers studied were liver and lung cancers accounting for 57.4% (N=995) and 15.4% (N=267), followed by esophageal (N=190) and breast cancer (N=134). The most common reported complications were bleeding (19%) and post-operative pain (14%). In our literature search, four independent studies showed upregulation and activation of the VEGF pathway following RFA, four showed upregulation and activation of the AKT pathway following RFA, three studies demonstrated involvement of matrix metalloproteinases, and four showed upregulation of c-Met protein following RFA. Conclusions: In our review and meta-analysis, we identify several proteins and pathways of interest of which are important in wound healing, angiogenesis, and cellular growth and survival. These proteins and pathways of interest may implicate areas of research towards RFA resistance and cancer recurrence. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-555/coif). The series “RFA and Recent Innovations in Endocrine Surgery” was commissioned by the editorial office without any funding or sponsorship. E.K. served as the unpaid Guest Editor of the series and serves as an Editor-in-Chief of Gland Surgery from May 2017 to April 2024. E.T. receives a research grant (THYROIDGRANT2021-0000000232) from the Bite Me Cancer and facilitated by the American Thyroid Association. The authors have no other conflicts of interest to declare. (2024 Gland Surgery. All rights reserved.)
Databáze:	MEDLINE
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