Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Oct 28, 2015; 7(10): 306-318
Published online Oct 28, 2015. doi: 10.4329/wjr.v7.i10.306
Locoregional treatment for hepatocellular carcinoma: The best is yet to come
Naveen Kalra, Pankaj Gupta, Yogesh Chawla, Niranjan Khandelwal
Naveen Kalra, Pankaj Gupta, Niranjan Khandelwal, Deparment of Radiodiagnosis and Imaging, PGIMER, Chandigarh 160012, India
Yogesh Chawla, Deparment of Hepatology, PGIMER, Chandigarh 160012, India
Author contributions: Kalra N conceived the issues which formed the content of the manuscript; Gupta P wrote the manuscript; Kalra N, Gupta P, Chawla Y and Khandelwal N revised the manuscript.
Conflict-of-interest statement: The authors have no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Naveen Kalra, MBBS, MD, Professor, Department of Radiodiagnosis and Imaging, PGIMER, Sector 12, Chandigarh 160012, India. navkal2004@yahoo.com
Telephone: +91-172-2756380
Received: April 10, 2015
Peer-review started: April 11, 2015
First decision: June 24, 2015
Revised: September 6, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: October 28, 2015
Processing time: 199 Days and 5 Hours
Abstract

Hepatocellular carcinoma (HCC) is the sixth-most common type of cancer worldwide. The only definitive treatment modalities capable of achieving a cure are hepatic resection and hepatic transplantation. However, most patients are not candidates for these therapies. Overall, treatment options are driven by the stage of HCC. Early-stage disease is treated with ablative therapies, with radiofrequency ablation the ablative therapy of choice. Microwave ablation and irreversible electroporation are the other upcoming alternatives. Intermediate-stage disease is managed with transarterial chemoembolization (TACE), while advanced-stage disease is managed by sorafenib, with TACE and radioembolization as other alternatives.

Keywords: Hepatocellular carcinoma; High intensity focussed ultrasound; Irreversible electroporation; Microwave ablation; Radiofrequency ablation

Core tip: Treatment of hepatocellular carcinoma is dependent on the stage of disease. Early-stage disease is managed by resection. Radiofrequency ablation (RFA), is becoming an attractive alternative for very early-stage disease. Early-stage disease is treated with ablative therapies. RFA is the ablative therapy of choice. RFA, however, is not effective in all cases. Microwave ablation and irreversible electroporation are upcoming alternatives. Transarterial chemoembolization (TACE) is the modality of choice for intermediate-stage disease. TACE-based multimodal treatment is becoming acceptable. Advanced-stage disease is managed by sorafenib. However, TACE and radioembolization are other alternatives.