Thermal ablation—an option in curative treatment of HCC

Abstract

Minimally invasive thermal ablation techniques are an integral part of international treatment guidelines in hepatocellular carcinoma (HCC). Due to highly effective local tumor control in nonresectable liver tumors with a relatively low rate of morbidity and mortality, thermal ablation even challenges the surgical approach as the first-line treatment in selected patients. Ablation outcome is largely dependent on the size and location of the HCC as well as on the applied ablation technique and image guidance. The creation of a sufficient ablation margin (A0 ablation in analogy to R0 resection) is prerequisite to assure low recurrence rates. In large tumors, tumorfree margins can be achieved only by overlapping ablation zones, which can be accomplished using stereotactic multiprobe ablation techniques (stereotactic radiofrequency ablation [SRFA], stereotactic microwave ablation [SMWA], stereotactic irreversible electroporation [SIRE]) in combination with 3D trajectory planning and image fusion for intraoperative evaluation of treatment results.

Simulation of Image-Guided Microwave Ablation Therapy Using a Digital Twin Computational Model

“…Ablation is employed as a curative treatment for early-stage clinical presentations of hepatic cancer and has taken on a critical role in disease management to bridge patients to transplant, improve quality of life, and contribute to novel combination therapies [88] , [89] , [115] . Additionally, the incidence and complications of liver cancer have been observed to be exacerbated by metabolic disorders associated with an evolving disease population, namely, the increasing incidences of cancer with NAFLD [2] , [3] , [7] , [38] .…”