Cryoablation for liver cancer

Primary cancer of the liver (hepatocellular carcinoma [HCC]) and metastatic cancer to the liver from a distant primary site of origin are very common problems in the United States and the world. The management of these diseases has become progressively complex as the available treatment options have improved and propagated. One option that has been gaining acceptance is image-guided tumor ablation. Image-guided tumor ablation has been applied to numerous cancers, including renal cell carcinoma, prostate cancer, lung cancer, and liver cancer with promising short-term results. Radiofrequency ablation has been the most widely studied and utilized ablation modality. However, cryoablation has several relative advantages (most significantly, the ability to produce larger and more precise zones of ablation) over RF ablation and the other heat-based ablation modalities. This manuscript is designed to be an up to date, practical and thorough review of the indications for, techniques of, and patient management issues associated with hepatic cryoablation.