Enhancing ablation: synergies with regional and systemic therapies

Ablative therapies often achieve complete response in solid tumors smaller than 3 cm, but local control becomes rapidly less common with increasing tumor diameter. Combining treatment modalities can increase the local control rate for larger tumors. Demonstrating the value of this is not straightforward. The prognosis of patients with higher-stage disease may not be improved by better control of their index tumor if their natural history is progression of disease at other sites. Combination therapies will need prospective evaluation for each tumor type and stage in randomized trials to elucidate the role of integrated therapies in global cancer care.