Thermal Ablation for Primary and Metastatic Hepatic Malignancies

Surgical resection offers the best hope for long-term survival in both hepatocellular carcinoma patients and those with metastatic liver disease. Patients most likely to benefit are those with a single tumor and well-preserved liver function, who have normal serum bilirubin and normal portal flow. Patients are often ineligible for resection for a variety of reasons. Ablative options, such as cryoablation and radiofrequency ablation (RFA), are minimally invasive procedures particularly suited for those patients who are felt to be poor surgical risks. These options are based on the principle that decreasing the volume of viable tumor or preventing new tumor growth can lead to longer survival and potential cure in selected patients. Complications related to these procedures are minimal compared with open surgery. The most common complications are bleeding and infection.