Local ablation therapy for hepatocellular carcinoma.

Several local ablation methods, most of which can be performed percutaneously under imaging guidance, have recently been developed as minimally invasive therapy for hepatocellular carcinoma (HCC). Among these, percutaneous ethanol injection has been the most widely performed and is now accepted as an attractive alternative to surgery in patients with small HCC. Other local ablation therapeutic options to achieve more effective tumor necrosis with less invasiveness have also been developed. Some of these techniques, such as microwave coagulation therapy and radiofrequency ablation, have already been introduced clinically. However, the real role of these new ablation methods in the treatment of HCC remains to be determined because of the lack of randomization and the small number of patients in the published series. Therefore, further trials, possibly randomized trials to compare the results of different options, are mandatory. Moreover, the prevention of recurrence after local ablation therapy for HCC has become an urgent problem to be resolved.