Transcutaneous Treatments of Hepatocellular Carcinoma in Patients with Cirrhosis: Present Status and Future Developments

Hepatocellular carcinoma is in 90% of cases associated with cirrhosis and to preserve liver function while destroying the tumor is a main issue in these patients justifying the development of local percutaneous ablative therapies. Alcoholization and radiofrequency ablation are the most widely used techniques of percutaneous ablation. Both have in common limitations linked to the size of the tumor and its situation and contra indications such has advanced liver disease and unpaired hemostasis. Radiofrequency ablation despite specific contra indications such as a close vicinity of the colon has shown better results in term of tumor necrosis local recurrence and even survival. For tumors less than 3cm in diameter results are comparable to those of surgical resection with a lesser morbidity. Due to this equivalence and the multiple contra indications of surgical resection in patients with cirrhosis radiofrequency ablation is becoming an increasingly popular technique for treating small hepatocellular carcinoma detected by screening.