The Evolving Role of Local Treatments for HCC in the Third Millennium

Abstract

Background: Hepatocellular carcinoma (HCC) represents the fifth most common malignancy and the third cancer-related cause of death worldwide. The aim of this review was to clarify the role of local treatments for HCC, analyzing the indications and defining future perspectives.

Materials and methods: A systematic literature search was performed independently by two of the authors according to the PRISMA statement guidelines. The search was limited to studies reported in English between January 2005 and June 2016.

Results: The literature search yielded 238 articles; after duplicates were removed, 179 titles and abstracts were reviewed. Most relevant data and articles about radiofrequency ablation, transarterial chemoembolization, percutaneous ethanol injection, microwave ablation and radioembolization are reported and discussed.

Conclusion: Data in the literature are confusing and difficult to compare due to the lack of prospective studies. Multidisciplinary and tailored approaches for each patient are key features, considering both guideline indications and patient-specific characteristics, and enhance hospital-specific best practice.

Keywords: Hepatocellular carcinoma; PEI; TACE; local treatments; microwave; review; thermo-ablation; yttrium-90.