Interstitial ablative techniques for hepatic tumours.
BACKGROUND
Most patients with liver tumours are not suitable for surgery but interstitial ablative techniques may control disease progression and improve survival rates.


METHODS
A review was undertaken using Medline of all reported studies of cryoablation, radiofrequency ablation, microwave ablation, interstitial laser photocoagulation, high-intensity focused ultrasound and ethanol ablation of primary liver tumours and hepatic metastases.


RESULTS
Although there are no randomized clinical trials, cryoablation, thermal ablation and ethanol ablation have all been shown to be associated with improved palliation in patients with primary and secondary liver cancer. The techniques can be undertaken safely with minimal morbidity and mortality.


CONCLUSIONS
Although surgical resection remains the first line of treatment for selected patients with primary and secondary liver malignancies, interstitial ablative techniques are promising therapies for patients not suitable for hepatic resection or as an adjunct to liver surgery.
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Department of Clinical and Surgical Sciences (Surgery), University of Edinburgh, Edinburgh, UK.
Parks
R W
RW
D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D018450:Disease Progression; D000431:Ethanol / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008113:Liver Neoplasms / Q000601:surgery*; D012997:Solvents / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
D012997:Solvents; D000431:Ethanol