Indian Society of Vascular and Interventional Radiology Expert Consensus Statements for Ablation in Hepatocellular Carcinoma: Part I

Abstract

Locoregional therapies play an important role in the management of hepatocellular carcinoma (HCC). Percutaneous ablation is one of the most commonly employed nonsurgical methods for treating very early and early HCC. For small HCCs, ablation is potentially curative and competes with surgical resection. The widespread availability and the spectrum of ablative techniques mandate uniform approach among interventional radiologists. Thus, it is desirable to have a consensus regarding various aspects of liver ablation. This article represents a consensus document of the experts from the Indian Society of Vascular and Interventional Radiology involved in the care of patients with HCC. The statements are presented in two parts.

Hybrid Laparoscopic and Ultrasound-Guided Thermal Ablation of Recurrent Renal Cell Carcinoma in a Patient with von Hippel-Lindau Disease and a Solitary Kidney

“…4 However, thermal ablation also carries risks and nontarget thermal injury may be seen. This risk can be reduced with introduction of a thermal protectant such as saline, dextrose, carbon dioxide, or an angioplasty balloon 5 as long as it can be appropriately delivered to the desired location.…”

Comparative Analysis of Radiofrequency Ablation and Microwave Ablation for Critically Located Hepatocellular Carcinomas Smaller than 5 cm

“…Percutaneous tumor ablation is one of the most commonly used nonsurgical methods for treating very early stage and early stage HCC. 2,14 RFA and MWA are the two most commonly used ablative techniques globally, with each having its own merits and demerits. RFA uses electrical current in radiofrequency range which is delivered through a needle electrode.…”

“…Majority of these cases are managed with percutaneous ablation therapies, which can be as effective as surgical techniques in terms of disease-free survival and overall survival. [2][3][4] Radiofrequency ablation (RFA) is the most common ablation technique used globally and is considered as safe and effective curative modality for treatment of HCC < 3 cm. 5 But RFA is generally risky when the tumor is subcapsular or located within 1 cm from the common bile duct or adjacent to visceral organs due to increased risk of complications.…”