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Percutaneous treatment of hepatocellular carcinoma: State of the art and innovations

  • Author Footnotes
    † This author was the recipient of the EASL Young Investigators’ Award 2017.
    Jean-Charles Nault
    Correspondence
    Corresponding authors. Addresses: APHP, Hôpitaux universitaires Paris – Seine Saint-Denis, Site Jean Verdier, Pôle d’Activité Cancérologique spécialisée, Service d’hépatologie, 93143 Bondy, France. Inserm UMR1162. Tel.: 01 53 72 51 94; fax: 01 53 72 51 92 (J.-C. Nault) or Hôpitaux universitaires Paris – Seine Saint-Denis, Site Jean Verdier, service de radiologie, 93143 Bondy, France., Inserm UMR1162. (O. Seror).
    Footnotes
    † This author was the recipient of the EASL Young Investigators’ Award 2017.
    Affiliations
    Liver Unit, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France

    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France

    Unité Mixte de Recherche 1162, Génomique fonctionnelle des tumeurs solides, Institut National de la Santé et de la Recherche Médicale, Paris, France
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  • Olivier Sutter
    Affiliations
    Department of Radiology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
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  • Pierre Nahon
    Affiliations
    Liver Unit, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France

    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France

    Unité Mixte de Recherche 1162, Génomique fonctionnelle des tumeurs solides, Institut National de la Santé et de la Recherche Médicale, Paris, France
    Search for articles by this author
  • Nathalie Ganne-Carrié
    Affiliations
    Liver Unit, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France

    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France

    Unité Mixte de Recherche 1162, Génomique fonctionnelle des tumeurs solides, Institut National de la Santé et de la Recherche Médicale, Paris, France
    Search for articles by this author
  • Olivier Séror
    Correspondence
    Corresponding authors. Addresses: APHP, Hôpitaux universitaires Paris – Seine Saint-Denis, Site Jean Verdier, Pôle d’Activité Cancérologique spécialisée, Service d’hépatologie, 93143 Bondy, France. Inserm UMR1162. Tel.: 01 53 72 51 94; fax: 01 53 72 51 92 (J.-C. Nault) or Hôpitaux universitaires Paris – Seine Saint-Denis, Site Jean Verdier, service de radiologie, 93143 Bondy, France., Inserm UMR1162. (O. Seror).
    Affiliations
    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France

    Unité Mixte de Recherche 1162, Génomique fonctionnelle des tumeurs solides, Institut National de la Santé et de la Recherche Médicale, Paris, France

    Department of Radiology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
    Search for articles by this author
  • Author Footnotes
    † This author was the recipient of the EASL Young Investigators’ Award 2017.
Published:October 13, 2017DOI:https://doi.org/10.1016/j.jhep.2017.10.004

      Summary

      Percutaneous treatment of hepatocellular carcinoma (HCC) encompasses a vast range of techniques, including monopolar radiofrequency ablation (RFA), multibipolar RFA, microwave ablation, cryoablation and irreversible electroporation. RFA is considered one of the main curative treatments for HCC of less than 5 cm developing on cirrhotic liver, together with surgical resection and liver transplantation. However, controversies exist concerning the respective roles of ablation and liver resection for HCC of less than 3 to 5 cm on cirrhotic liver. In line with the therapeutic algorithm of early HCC, percutaneous ablation could also be used as a bridge to liver transplantation or in a sequence of upfront percutaneous treatment, followed by transplantation if the patient relapses. Moreover, several innovations in ablation methods may help to efficiently treat early HCC, initially considered as “non-ablatable”, and might, in some cases, extend ablation criteria beyond early HCC, enabling treatment of more patients with a curative approach.

      Keywords

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