ABSTRACT
Recently, several minimally invasive, image-guided therapies have been developed for
the local treatment of hepatocellular carcinoma (HCC) and hepatic metastases in patients
who are considered poor candidates for surgical resection. Radio-frequency ablation,
microwave ablation, and laser ablation all destroy tumor by creating a hyperthermic
injury. Cryoablation and ethanol ablation achieve cellular death through freezing
and direct toxicity, respectively. Chemoembolization is unique in that the entire
liver can be treated over time with a combination of cytotoxic drugs and embolic agents,
potentially reducing the rate of recurrence from radiologically occult tumor. Outcomes
for minimally invasive therapy have approached the success rate of surgical resection
in some series with considerably fewer complications. However, a paucity of randomized
trials and variability in reporting limit assessment of the relative role of these
techniques in clinical practice. With a few exceptions, the indications, contraindications,
and complications associated with the different techniques are similar, and success
with HCC has exceeded that for metastatic disease independent of technique.
KEYWORD
Hepatocellular carcinoma - hepatic metastases - image-guided ablation
