Ablative strategies for recurrent hepatocellular carcinoma

Area of Science:

• Oncology
• Gastroenterology
• Surgical Innovation

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally.
• While liver transplantation, resection, and ablation are curative, HCC recurrence is frequent (up to 70% within 5 years).
• Recurrent HCC (rHCC) management is challenging due to limitations in surgical options and donor organ availability.

Purpose of the Study:

• To systematically review diverse ablation techniques for treating recurrent HCC (rHCC).
• To highlight ablation as a viable option for rHCC management, especially when other treatments are contraindicated or unavailable.
• To discuss the role of ablation in preparing patients for liver transplantation.

Main Methods:

• Systematic review of literature on ablation therapies for rHCC.
• Inclusion of various ablation modalities: radiofrequency, microwave, laser, high-intensity focused ultrasound, cryoablation, irreversible electroporation, and percutaneous ethanol injection.
• Consideration of combination therapies involving ablation.

Main Results:

• Local ablation is a crucial alternative for rHCC, particularly for oligo-recurrence.
• Ablation serves as a bridge to liver transplantation and can be used post-transplantation to manage recurrence.
• A comprehensive overview of multiple ablation techniques is presented.

Conclusions:

• Ablation therapies offer effective management strategies for recurrent HCC.
• The choice of ablation technique depends on individual patient and tumor characteristics.
• Ablation plays a significant role in the multidisciplinary approach to HCC recurrence.