title: Locally ablative therapies for primary and metastatic liver cancer.
abstract: Locally ablative therapies have an increasing role in the effective multidisciplinary approach towards the treatment of both primary and metastatic liver tumors. In patients who are not considered surgical candidates and have low volume disease, these therapies have now become established into consensus practice guidelines. A large range of therapeutic options exist including percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation, percutaneous laser ablation (PLA), irreversible electroporation (IRE), stereotactic body radiation therapy (SBRT) and high intensity focused ultrasound (HIFU); each having benefits and drawbacks. The greatest body of evidence supporting clinical utility in the liver currently exists for RFA, with PEI having fallen out of favor. MWA, IRE, SBRT and HIFU are relatively nascent technologies, and outcomes data supporting their use is promising. Future directions of ablative therapies include tandem approaches to improve efficacy in the treatment of liver tumors.
authors.affiliation: Department of Radiology, Division of Interventional Radiology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Li
authors.forename: Josephine
authors.initials: J
authors.lastname: Kang
authors.forename: David C
authors.initials: DC
authors.lastname: Madoff
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000818:Animals; D017115:Catheter Ablation / Q000379:methods; D003452:Cryosurgery / Q000379:methods; D053672:Electrochemotherapy / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D017410:Practice Guidelines as Topic; D016634:Radiosurgery / Q000379:methods
chemical_list: D000431:Ethanol
keywords: ablation; hepatocellular carcinoma; high-intensity focused ultrasound; liver; metastasis; microwave; radiofrequency; radiosurgery; stereotactic body radiation therapy; thermal