24 Microwave ablation therapy for hepatocellular carcinoma

Objectives Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related deaths worldwide. Microwave ablation is regarded as a safe and effective therapy for the treatment of HCC and has gained considerable attention as a rapidly expanding curative ablation option. This study aims to review the current application of microwave ablation therapy (MAT) for HCC. Methods A literature search was conducted in the PubMed (MEDLINE) database from inception up to August 2016, with no limitations imposed on language or study type, about the application of MAT for HCC. Results MAT for HCC has been reported to be effectively delivered through open laparotomy, laparoscopy and a percutaneous approach for appropriate patients, with many different tools for imaging guidance, including ultrasound, X-ray fluoroscopy, CT, MRI, PET-CT and combined US/CT-MRI. MAT provides the advantages of short treatment duration, a controllable wound and large ablation areas, and may even have the potential to enhance host resistance to malignancies. It is recommended as a first-line therapy for patients with very early and early stage HCC, and is a palliative option for advanced HCC. For tumors larger than 3 cm in diameter with an incomplete capsule, or with visible satellite lesions, or tumors in difficult anatomic locations, combination therapy with other treatments, such as TACE, PEI, iodine-125 particles, immunotherapy, etc, should be considered. Conclusions MAT has gained recognition in the treatment of early or advanced HCC. With the development of image guidance, multiple innovative instruments and different combination therapy modalities, MAT is a promising therapy for development and clinical application in the future. Acknowledgments This research was financially supported by Sichuan University (Grant No. 2016SCU11033).