Local ablation therapy for hepatocellular carcinoma - From ethanol injection to radiofrequency ablation

This article reviews the current status of local ablation therapy for hepatocellular carcinoma (HCC). In the treatment of HCC, non-surgical treatments play important roles since only 20-30% of patients are candidates for surgery. Still worse, even after curative surgical resection, 80% of patients develop recurrence within 5 years. Among non-surgical treatments, image-guided local ablation therapies have been widely used for cases of small-number and small-size lesions, because they are potentially curative, minimally invasive, and easily repeatable. Although percutaneous ethanol injection has long been a standard therapy, there has been a drastic shift from ethanol injection to radiofrequency ablation in recent years. Randomized controlled trials proved that radiofrequency ablation is superior to ethanol injection in the treatment of HCC from the viewpoint of not only treatment response but also long-term survival. Radiofrequency ablation will play more important roles in the treatment of HCC.