scholarly journals Percutaneous Ablation-Induced Immunomodulation in Hepatocellular Carcinoma

2020 ◽  
Vol 21 (12) ◽  
pp. 4398 ◽  
Author(s):  
Lucile Dumolard ◽  
Julien Ghelfi ◽  
Gael Roth ◽  
Thomas Decaens ◽  
Zuzana Macek Jilkova
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Thermal Ablation ◽  
Microwave Ablation ◽  
Treatment Options ◽  
Ablation Techniques ◽  
High Rate ◽  
Percutaneous Ablation ◽  
Ablative Therapies ◽  
Immune Changes

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide and its incidence is rising. Percutaneous locoregional therapies, such as radiofrequency ablation and microwave ablation, are widely used as curative treatment options for patients with small HCC, but their effectiveness remains restricted because of the associated high rate of recurrence, occurring in about 70% of patients at five years. These thermal ablation techniques have the particularity to induce immunomodulation by destroying tumours, although this is not sufficient to raise an effective antitumour immune response. Ablative therapies combined with immunotherapies could act synergistically to enhance antitumour immunity. This review aims to understand the different immune changes triggered by radiofrequency ablation and microwave ablation as well as the interest in using immunotherapies in combination with thermal ablation techniques as a tool for complementary immunomodulation.

scholarly journals Histological Correlation for Radiofrequency and Microwave Ablation in the Local Control of Hepatocellular Carcinoma (HCC) before Liver Transplantation: A Comprehensive Review

Cancers ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 104
Author(s):  
Peiman Habibollahi ◽  
Rahul A. Sheth ◽  
Erik N. K. Cressman
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Microwave Ablation ◽  
Liver Tumors ◽  
High Specificity ◽  
Lesion Size ◽  
Ablation Techniques ◽  
High Rate ◽  
Pathological Findings ◽  
Comprehensive Review

Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most widely studied and applied ablation techniques for treating primary and secondary liver tumors. These techniques are considered curative for small hepatic tumors, with post-ablation outcomes most commonly assessed by an imaging follow up. However, there is increasing evidence of a discrepancy between radiological and pathological findings when ablated lesions are evaluated following liver resection or liver transplantation. A comprehensive review of the available literature reporting the complete pathological response (cPR) following RFA and MWA was performed to estimate the success rate and identify the factors associated with treatment failure. Following RFA, cPR is reported in 26–96% of tumors compared to 57–95% with MWA. Larger tumor size and vessels larger than 3 mm adjacent to the treated tumor are the most important factors identified by previous studies associated with viable residual tumors after RFA. Correlating post-ablation radiological studies with pathological findings shows that computed tomography (CT) and magnetic resonance imaging (MRI) have low sensitivity but high specificity for detecting residual viable or recurrent hepatocellular carcinoma (HCC) tumors. There are promising recent reports combining multiprobe ablation techniques with three-dimensional treatment planning software and stereotactic-aiming instrumentation to achieve more than 90% cPR in both small and large HCC tumors. In conclusion, the reported success for achieving cPR in HCC following RFA and MWA is highly variable in different studies and decreases with increasing lesion size and unfavorable tumor characteristics. Very few studies have reported a high rate of cPR. As these studies are single-center and retrospective, they need to be further validated and reproduced in other clinical settings.

scholarly journals Percutaneous Ablation for Hepatocellular Carcinoma: Comparison of Various Ablation Techniques and Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Shuichiro Shiina ◽  
Koki Sato ◽  
Ryosuke Tateishi ◽  
Motonori Shimizu ◽  
Hideko Ohama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Microwave Ablation ◽  
Irreversible Electroporation ◽  
Percutaneous Ablation ◽  
Term Survival ◽  
Ethanol Injection ◽  
Class A ◽  
Pugh Class

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.

Recent Advances in Local Thermal Ablation Therapy for Hepatocellular Carcinoma

2021 ◽  
pp. 000313482110545
Author(s):  
Min Deng ◽  
Shao-Hua Li ◽  
Rong-Ping Guo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Thermal Ablation ◽  
Good Choice ◽  
Local Tumor Recurrence ◽  
Ablation Therapy ◽  
First Line Therapy ◽  
Thermal Ablation Therapy ◽  
Arterial Chemoembolization

Image-guided local thermal ablation (LTA) plays an important role in the treatment of hepatocellular carcinoma (HCC), especially in patients with HCC who are not suitable for hepatectomy. Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most widely used LTA clinically. Radiofrequency ablation can achieve the best result; that is, a similar therapeutic effect as hepatectomy if the tumor ≤3 cm, while MWA can effectively ablate tumors ≤5 cm. Local thermal ablation has an advantage over liver resection in terms of minimally invasive surgery and can achieve a comparable prognosis and efficacy to liver resection. For borderline liver function, selecting LTA as the first-line therapy may bring more benefits to patients with cirrhosis background. In addition, a combination of multiple therapies for HCC is a good choice, such as LTA combined with transcatheter arterial chemoembolization (TACE), which can achieve a better prognosis than single therapy for larger tumors. For patients who are awaiting liver transplantation, LTA is a good choice. The main problem of LTA needed to be solved is to prevent the local tumor recurrence after ablation in patients with HCC.

scholarly journals Thermal Ablation of Metastatic Colon Cancer to the Liver

2019 ◽  
Vol 36 (04) ◽  
pp. 310-318 ◽  
Author(s):  
Juan C. Camacho ◽  
Elena N. Petre ◽  
Constantinos T. Sofocleous
Keyword(s):  
Liver Metastases ◽  
Thermal Ablation ◽  
Interventional Oncology ◽  
Percutaneous Ablation ◽  
Western World ◽  
Metastatic Colon Cancer ◽  
Term Survival ◽  
Ablative Therapies

AbstractColorectal cancer (CRC) is responsible for approximately 10% of cancer-related deaths in the Western world. Liver metastases are frequently seen at the time of diagnosis and throughout the course of the disease. Surgical resection is often considered as it provides long-term survival; however, few patients are candidates for resection. Percutaneous ablative therapies are also used in the management of this patient population. Different thermal ablation (TA) technologies are available including radiofrequency ablation, microwave ablation (MWA), laser, and cryoablation. There is growing evidence about the role of interventional oncology and image-guided percutaneous ablation in the management of metastatic colorectal liver disease. This article aims to outline the technical considerations, outcomes, and rational of TA in the management of patients with CRC liver metastases, focusing on the emerging role of MWA.

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