Thermal ablation of large unresectable hepatocellular carcinoma in cirrhotic patients

Abstract

Hepatocellular carcinoma (HCC) is one of the most common and lethal malignancies worldwide. Surgery is the mainstay of treatment, but less than 20%-30% of patients are good candidates. Actually, thermal ablation is considered the best treatment with curative intent for cirrhotic patients with unresectable HCC ≤ 3 cm. Unfortunately, radio frequency efficacy in obtaining the complete ablation of HCC nodules diminishes with increasing tumor size and local tumor progression is more frequent in larger nodules. To overcome these problems, higher-powered generators, different devices and techniques have been attempted. Furthermore, microwave ablation has been introduced with the promise of a large ablative capacity. The aim of this review is to describe the role of thermal ablation for the treatment of large unresectable HCC.

Pure laparoscopic liver resection versus percutaneous radiofrequency ablation for small hepatocellular carcinoma: a propensity score and multivariate analysis

“…This meta-analysis showed that LLR had a significantly better 5-year overall survival and better 1- and 3-year disease-free survival than RFA. Tumor size is one of the important factors in considering ablative treatment as the efficacy in complete ablation diminished with larger tumour size and local tumour progression was more frequent in larger tumours ( 22 ).…”