Application of ablative therapy for intrahepatic recurrent hepatocellular carcinoma following hepatectomy

Table 1 Description characteristics of different ablation modalities

Ablation modalities	Advantages	Limitations
RFA[13,14]	Most widely used and mature technology	Limited zone of monopolar centrifugal ablation
	Multibipolar RFA for larger and more modulable ablation zones	Sensitive to heat sink effect
		Influenced by tissue conductance
MWA[13,14]	Higher temperature and faster heating of larger target over RFA	Complex and technically demanding operation
	Less sensitive to heat sink effect	Thermal injury from higher temperature
	Less influenced by tissue conductance
PEI[42]	Simple to perform, inexpensive	Small size of ablation zone
	Chemo-ablation: No thermal injury	High local recurrence rate
HIFU[47]	Noninvasive operation: No worry of needle tract seeding	Time consuming
		Influenced by ultrasoundpropagation and artifacts, respiration motion
CRA[13,48]	Less pain	High cost
	Well-visualized ice ball on imaging for precise monitoring	Cryoshock (more often in early device)
IRE[13,14]	Nonthermal ablation: low risk of thermal injury	Risk of myoclonia and arrhythmias
	Less sensitive to heat-sink effect	Limited clinical data
	Well preserved connective tissue, blood vessels and bile ducts
	Less frequent liver failure

RFA: Radiofrequency ablation; MWA: Microwave ablation; PEI: Percutaneous ethanol injection; HIFU: High-intensity focused ultrasound ablation; CRA: Cryoablation; IRE: Irreversible electroporation.