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Hepatocellular Carcinoma pp 453–466Cite as

Thermal Ablative Treatments for Hepatocellular Carcinoma

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Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Ablative treatments currently represent the first-line option for the treatment of early stage unresectable hepatocellular carcinoma (HCC) and are effective as bridging/downstaging therapies before orthotopic liver transplantation. Among ablative therapies, radiofrequency ablation (RFA) has gained a pivotal role due to its efficacy (5-year survival rate of 40–70 %) and cost-effectiveness. Despite the undoubted efficacy of RFA, indeed, tumor recurrence remains a major problem when treating HCC. Therefore, in the last years, a number of drugs such as sorafenib, ACE I, and interferon, have been tested as adjuvant treatment in order to decrease the high recurrence rate after RFA but no agent has been proved to be effective in this specific setting. Some promising results have been recently presented with regard to sartans but further confirmations are needed. There is increasing evidence that combining RFA to TACE may increase the therapeutic benefit in larger HCCs without increasing the major complication rate, but more robust prospective data are still needed to validate these findings. Among other thermal treatments, microwave ablation (MWA) has several theoretical advantages: a broader zone of active heating, higher temperatures within the targeted area in a shorter treatment time, and the lack of heat sink effect. However, safety concerns have been recently raised on the risks of this procedure. Other treatments, such as high-intensity focused ultrasound ablation (HIFU), laser ablation (LA), and cryoablation, are less investigated but showed promising results in early HCC patients and could be a valuable therapeutic option in the next future.

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Authors and Affiliations

  1. Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Ospedali Riuniti Foggia, Foggia, Italy

    Antonio Facciorusso

  2. Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 11, 70124, Bari, Italy

    Michele Barone

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  1. Dokuz Eylul University, Izmir Biomedicine and Genome Center Dokuz Eylul University, Izmir, Izmir, Turkey

    Brian I. Carr

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Facciorusso, A., Barone, M. (2016). Thermal Ablative Treatments for Hepatocellular Carcinoma. In: Carr, B. (eds) Hepatocellular Carcinoma. Current Clinical Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-34214-6_30

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