Interventional treatments for hepatocellular carcinoma.
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most frequent primary malignant tumors in the world. Hepatic resection and liver transplantation are considered optimal for potential treatment of HCC. However, only 20% of HCCs can be surgically treated. And most of surgically-noneligible patients have to receive interventional managements including local ablation and transarterial chemoembolization (TACE). In this paper, we review the interventional treatments of HCC.


METHODS
A literature search of PubMed database was conducted and research articles were reviewed.


RESULTS
Percutaneous ethanol injection (PEI) is usually applied to small HCC for a complete necrosis. Radiofrequency ablation, an alternative to PEI, also causes tumor necrosis and needs fewer times of ablation. Other methods such as acetic acid injection, laser, microwave, etc have enriched local ablation for HCC. High intensity focus ultrasound (HIFU) is thought to be promising. TACE, another common modality, can improve the survival rate of patients with HCC. The newly developed embolic agents and adjuvant rAd-p53 gene therapy are well reported.


CONCLUSIONS
Surgically-noneligible HCC can be treated with interventional procedures. Each method has its advantages and disadvantages. However, it is still pressing to develop ablative methods as well as new embolic agents for a better prognosis of HCC.
Guan
Yong-Song
YS
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China. YongsongGuan@yahoo.com
Liu
Yuan
Y
D019342:Acetic Acid / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003452:Cryosurgery; D000431:Ethanol / Q000627:therapeutic use; D006801:Humans; D006979:Hyperthermia, Induced; D008113:Liver Neoplasms / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use; D014464:Ultrasonic Therapy
D000431:Ethanol; D019342:Acetic Acid