Guideline-based thermal ablation of hepatocellular carcinoma

Background Hepatocellular carcinoma (HCC) is fifth most common cancer worldwide. The German S3 guideline on the diagnosis and the treatment of hepatocellular and biliary carcinoma was recently revised. Objective Determination of the current status of thermal ablation in HCC according to the German S3 guideline. Materials and methods Based on the current guideline and a selective literature search, the current status on indication and application of thermal ablation in HCC was revisited. Results Radiofrequency ablation (RFA) and microwave ablation (MWA) provide similar survival when compared with surgery. Accordingly, RFA und MWA are considered first-line treatments for HCCs <= 3 cm in cirrhotic livers. For HCCs with diameters of 3-5 cm, a combination of transarterial chemoembolization and thermal ablation is recommended. Conclusion The current S3 guideline on diagnosis and treatment of HCC comprises relevant changes regarding thermal ablation in HCC. The overall role of interventional oncology procedures in the treatment of HCC was reinforced.

Automated summary

According to the German S3 guideline, radiofrequency ablation and microwave ablation have similar survival rates compared to surgery in the treatment of hepatocellular carcinoma. Combination of transarterial chemoembolization and thermal ablation is recommended for hepatocellular carcinomas with diameters of 3-5 cm.