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World J Gastrointest Surg. Jan 27, 2023; 15(1): 9-18
Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.9
Application of ablative therapy for intrahepatic recurrent hepatocellular carcinoma following hepatectomy
Rong Cong, Xiao-Hong Ma, Shuang Wang, Bing Feng, Wei Cai, Zhao-Wei Chen, Xin-Ming Zhao
Rong Cong, Xiao-Hong Ma, Shuang Wang, Bing Feng, Wei Cai, Zhao-Wei Chen, Xin-Ming Zhao, Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Cong R performed literature review and drafted the manuscript; Cai W and Chen ZW contributed to data collection of the study; Wang S, Feng B, and Zhao XM reviewed the manuscript; Ma XH contributed to conception and design of the study, and critically revised this manuscript; all authors have read and approved the final manuscript.
Supported by the National Key Research and Development Program of China, No. 2020AAA0109503.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Hong Ma, MD, Associate Professor, Doctor, Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. maxiaohong@cicams.ac.cn
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: October 21, 2022
Revised: November 20, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 27, 2023
Abstract

The post-hepatectomy recurrence rate of hepatocellular carcinoma (HCC) is persistently high, affecting the prognosis of patients. An effective therapeutic option is crucial for achieving long-term survival in patients with postoperative recurrences. Local ablative therapy has been established as a treatment option for resectable and unresectable HCCs, and it is also a feasible approach for recurrent HCC (RHCC) due to less trauma, shorter operation times, fewer complications, and faster recovery. This review focused on ablation techniques, description of potential candidates, and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.

Keywords: Hepatocellular carcinoma, Recurrence, Ablation techniques, Radiofrequency ablation, Combined therapy, Therapeutic index

Core Tip: The high recurrence rate of hepatocellular carcinoma (HCC) remains a global health challenge, which urges close surveillance following hepatectomy for earlier detection of recurrent HCC. Unlike primary HCC, recurrent HCCs are usually detected in the early stage but are not amenable to repeat hepatectomy after comprehensive evaluation. The value of ablation as a minimally invasive but curative method is an increasing concern. We herein discuss the role of various ablation modalities and procedures in treating intrahepatic recurrent HCC for guiding its better application.