Ablation of Hepatocellular Carcinoma

Ablation is an effective alternative to resection for very early and early stages of hepatocellular carcinoma (HCC) according to the criteria of the Barcelona Clinic Liver Cancer Staging System. There is a wide range of ablation techniques, including mono- and multipolar radiofrequency ablation, microwave ablation and irreversible electroporation. In contrast to the other techniques, irreversible electroporation is not temperature-based and can therefore be used in the vicinity of large bile ducts and vessels. For HCC larger than 3 cm, ablation should be combined with transarterial chemoembolization. In recent years, technical developments have contributed to the efficient and curative treatment of at-risk-location and large HCCs, which were previously regarded as “non-ablatable”. Percutaneous ablation can also be successfully used as a bridging technique for liver transplant patients.