Thermal ablation for unresectable liver tumours, time to move forward?

Even with the advent of laparoscopic techniques for liver tumours, classic resections still represent a major undertaking for numerous liver lesions. The avoidance of surgery using ablative techniques has been the aim for over 20 years. Large volumes can now be rapidly treated with low morbidity with the many technical developments and modifications of the delivery probes. Despite these advances recurrences rates remain high with all of the presently available techniques. The biological and pathophysiological basis underlying may help explain their limitations and are important in understanding where they may be appropriately applied and ways in which they may be improved in the future.