20. What is the Future of Image-Guided Radiofrequency Ablation for Hepatocellular Carcinoma?

  1. Roger Williams CBE, MD, FRCP, FRCS, FMedSci2 and
  2. Simon D. Taylor-Robinson MD, DA, EUMS, FRCP3
  1. Riccardo Lencioni MD

Published Online: 29 NOV 2011

DOI: 10.1002/9781119962205.ch20

Clinical Dilemmas in Primary Liver Cancer

Clinical Dilemmas in Primary Liver Cancer

How to Cite

Lencioni, R. (2011) What is the Future of Image-Guided Radiofrequency Ablation for Hepatocellular Carcinoma?, in Clinical Dilemmas in Primary Liver Cancer (eds R. Williams and S. D. Taylor-Robinson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119962205.ch20

Editor Information

  1. 2

    The Institute of Hepatology London, The Foundation for Liver Research, London, UK

  2. 3

    Department of Medicine, Imperial College London, London, UK

Author Information

  1. Division of Diagnostic Imaging and Intervention, University of Pisa School of Medicine, Pisa, Italy

Publication History

  1. Published Online: 29 NOV 2011
  2. Published Print: 3 DEC 2011

ISBN Information

Print ISBN: 9780470657973

Online ISBN: 9781119962205

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Keywords:

  • radiofrequency ablation;
  • ethanol injection;
  • combination therapy;
  • sorafenib

Summary

Image-guided tumour ablation is recommended in patients with early-stage hepatocellular carcinoma (HCC) when surgical options are precluded. Radiofrequency ablation (RFA) has shown superior anticancer effect and greater survival benefit with respect to the seminal percutaneous technique, ethanol injection, in meta-analyses of randomised controlled trials, and is currently established as the standard method for local tumour treatment. Novel thermal and non-thermal techniques for tumour ablation seem to have potential to overcome the limitations of RFA and warrant further clinical investigation. The recent addition of molecular targeted drugs with anti-angiogenic and antiproliferative properties to the therapeutic armamentarium for HCC has prompted the design of clinical trials aimed at investigating the synergies between local ablation and systemic treatments. The outcomes of these trials are eagerly awaited, as they have the potential to revolutionize the treatment of HCC.