Challenges Facing Percutaneous Ablation in the Treatment of Hepatocellular Carcinoma: Extension of Ablation Criteria

J Hepatocell Carcinoma. 2021 Jun 21:8:625-644. doi: 10.2147/JHC.S298709. eCollection 2021.

Abstract

As an emerging minimally invasive treatment method, percutaneous ablation is more and more widely used in the treatment of liver tumors. It has been recommended by guidelines for diagnosis and treatment of hepatocellular carcinoma (HCC) as a curative treatment alongside surgical resection and liver transplantation. In recent years, with the continuous advancement and innovation of percutaneous ablation technologies, their clinical efficacy and safety have been significantly improved, which has led to the expanded application of percutaneous ablation in the treatment of HCC-more and more patients who were previously considered unsuitable for ablation therapies are now being treated with percutaneous ablation. Obviously, percutaneous ablation can reduce the risk of treatment changes from curative strategies to palliative strategies. Based on clinical practice experience, this review enumerates the advantages and disadvantages of different ablative modalities and summarizes the existing combinations of ablation techniques, thus will help clinicians choose the most appropriate ablative modality for each patient and will provide scientific guidance for improving prognosis and making evidence-based treatment decisions. In addition, we point out the challenges and future prospects of the ablation therapies, thereby providing direction for future research.

Keywords: assistive technology; hepatocellular carcinoma; image guidance; percutaneous ablation.

Publication types

  • Review

Grants and funding

The study was funded by Natural Science Foundation of Henan Province [162300410270]; Science and Technology Development Foundation of Henan Province [212102310115, 212102310135]; Henan Provincial Medical Science and Technology Project [SBGJ202002025, SBGJ202003009]; Henan Medical Science and Technology Innovation Talent Project [YXKC2020045].