A primer on transarterial, chemical, and thermal ablative therapies for hepatic tumors.
BACKGROUND
Surgical resection is the only potentially curative approach for patients with primary and metastatic liver tumors. Unfortunately, most patients with hepatic malignancy are precluded from resection due to multifocal disease, anatomic limitations, inadequate functional liver reserve, extrahepatic metastases, or medical comorbidities. Consequently, several methods of tumor ablation have been developed as alternate treatment strategies for patients with unresectable hepatic tumors or as adjuncts in total cancer therapy. The purpose of this review is to inclusively define the various ablation modalities available (transarterial, chemical, and thermal ablative), and to describe the procedures, general applications, and reported outcomes.


METHODS
A MEDLINE and CINAHL search of the English-language literature was performed on transarterial, chemical, and thermal ablative therapies.


CONCLUSIONS
Presently, radiofrequency thermal ablation is the most widely applicable liver-directed modality for hepatic tumor ablation, enabling treatment of primary and metastatic tumors. However, other transarterial and thermoablative techniques are available with accumulating data for their use. Lacking at present are studies that define the role and potential benefit of the various liver-directed modalities in the treatment algorithm for hepatic tumors.
Garrean
Sean
S
Department of Surgery, University of Illinois at Chicago, 840 South Wood Street, M/C 958, Chicago, IL 60612, USA.
Hering
Justin
J
Helton
W Scott
WS
Espat
N Joseph
NJ
D019342:Acetic Acid / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D017115:Catheter Ablation; D003452:Cryosurgery; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage; D006801:Humans; D007269:Injections, Intra-Arterial; D015552:Injections, Intralesional; D053685:Laser Therapy; D008113:Liver Neoplasms / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use; D014464:Ultrasonic Therapy
D000970:Antineoplastic Agents; D000431:Ethanol; D019342:Acetic Acid