Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery
Image-guided percutaneous ablation is considered best in the treatment of early-stage hepatocellular carcinoma (HCC). Ablation is potentially curative, minimally invasive, and easily repeatable for recurrence. Ethanol injection used to be the standard in ablation. However, radiofrequency ablation ha...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/4756147 |
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| author | Shuichiro Shiina Koki Sato Ryosuke Tateishi Motonori Shimizu Hideko Ohama Takeshi Hatanaka Masashi Takawa Hiroaki Nagamatsu Yasuharu Imai |
| author_facet | Shuichiro Shiina Koki Sato Ryosuke Tateishi Motonori Shimizu Hideko Ohama Takeshi Hatanaka Masashi Takawa Hiroaki Nagamatsu Yasuharu Imai |
| author_sort | Shuichiro Shiina |
| collection | DOAJ |
| description | Image-guided percutaneous ablation is considered best in the treatment of early-stage hepatocellular carcinoma (HCC). Ablation is potentially curative, minimally invasive, and easily repeatable for recurrence. Ethanol injection used to be the standard in ablation. However, radiofrequency ablation has recently been the most prevailing ablation method for HCC. Many investigators have reported that radiofrequency ablation is superior to ethanol injection, from the viewpoints of treatment response, local tumor curativity, and overall survival. New-generation microwave ablation can create a larger ablation volume in a shorter time period. Further comparison studies are, however, mandatory between radiofrequency ablation and microwave ablation, especially in terms of complications and long-term survival. Irreversible electroporation, which is a non-thermal ablation method that delivers short electric pulses to induce cell death due to apoptosis, requires further studies, especially in terms of long-term outcomes. It is considerably difficult to compare outcomes in ablation with those in surgical resection. However, radiofrequency ablation seems to be a satisfactory alternative to resection for HCC 3 cm or smaller in Child-Pugh class A or B cirrhosis. Furthermore, radiofrequency ablation may be a first-line treatment in HCC 2 cm or smaller in Child-Pugh class A or B cirrhosis. Various innovations would further improve outcomes in ablation. Training programs may be effective in providing an excellent opportunity to understand basic concepts and learn cardinal skills for successful ablation. Sophisticated ablation would be more than an adequate alternative of surgery for small- and possibly middle-sized HCC. |
| format | Article |
| id | doaj-art-7696c76b9e0b4e5cbba091549e4b6125 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-7696c76b9e0b4e5cbba091549e4b61252025-08-20T03:35:15ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/47561474756147Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and SurgeryShuichiro Shiina0Koki Sato1Ryosuke Tateishi2Motonori Shimizu3Hideko Ohama4Takeshi Hatanaka5Masashi Takawa6Hiroaki Nagamatsu7Yasuharu Imai8Department of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, The University of Tokyo, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanDepartment of Gastroenterology, Juntendo University School of Medicine, JapanImage-guided percutaneous ablation is considered best in the treatment of early-stage hepatocellular carcinoma (HCC). Ablation is potentially curative, minimally invasive, and easily repeatable for recurrence. Ethanol injection used to be the standard in ablation. However, radiofrequency ablation has recently been the most prevailing ablation method for HCC. Many investigators have reported that radiofrequency ablation is superior to ethanol injection, from the viewpoints of treatment response, local tumor curativity, and overall survival. New-generation microwave ablation can create a larger ablation volume in a shorter time period. Further comparison studies are, however, mandatory between radiofrequency ablation and microwave ablation, especially in terms of complications and long-term survival. Irreversible electroporation, which is a non-thermal ablation method that delivers short electric pulses to induce cell death due to apoptosis, requires further studies, especially in terms of long-term outcomes. It is considerably difficult to compare outcomes in ablation with those in surgical resection. However, radiofrequency ablation seems to be a satisfactory alternative to resection for HCC 3 cm or smaller in Child-Pugh class A or B cirrhosis. Furthermore, radiofrequency ablation may be a first-line treatment in HCC 2 cm or smaller in Child-Pugh class A or B cirrhosis. Various innovations would further improve outcomes in ablation. Training programs may be effective in providing an excellent opportunity to understand basic concepts and learn cardinal skills for successful ablation. Sophisticated ablation would be more than an adequate alternative of surgery for small- and possibly middle-sized HCC.http://dx.doi.org/10.1155/2018/4756147 |
| spellingShingle | Shuichiro Shiina Koki Sato Ryosuke Tateishi Motonori Shimizu Hideko Ohama Takeshi Hatanaka Masashi Takawa Hiroaki Nagamatsu Yasuharu Imai Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery Canadian Journal of Gastroenterology and Hepatology |
| title | Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery |
| title_full | Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery |
| title_fullStr | Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery |
| title_full_unstemmed | Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery |
| title_short | Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery |
| title_sort | percutaneous ablation for hepatocellular carcinoma comparison of various ablation techniques and surgery |
| url | http://dx.doi.org/10.1155/2018/4756147 |
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