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Hépato-Gastro & Oncologie Digestive

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Percutaneous treatments of hepatocellular carcinoma: which method for which patient? Volume 22, issue 1, Janvier 2015

Figures


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Tables

Authors
1 Hôpitaux Universitaires Paris-Seine-Saint-Denis, site Jean Verdier, pôle d’activités cancérologiques spécialisées, service d’hépatologie, F-93143 Bondy, France
2 Université Paris 13, Sorbonne Paris Cité, UFR SMBH, F-93000 Bobigny, France
3 Inserm, UMR-1162, génomique fonctionnelle des tumeurs solides, IUH, Paris, F-75010 Paris, France
4 Hôpitaux Universitaires Paris-Seine-Saint-Denis, site Jean Verdier, service de radiologie, F-93143 Bondy, France
5 Hôpitaux Universitaires Paris-Seine Saint-Denis, site Jean Verdier, service d’anatomo-pathologie, F-93143 Bondy, France
* Tirés à part

Percutaneous ablation is the main non-surgical curative treatment of hepatocellular carcinoma (HCC) treatment. Monopolar radiofrequency (RF) is used to treat one HCC of less than 3 cm or a maximum of 3 HCC whose maximal diameter is 3 cm (BCLC 0/A) and could be used in patients with portal hypertension and mild liver failure (Child Pugh B6/7). Moreover, it could be used to treat tumor recurrence. RF ablation could also be an alternative to liver resection in front of uninodular HCC of less than 3 cm in Child Pugh A patients without portal hypertension and be used as a first line treatment followed by potential salvage liver transplantation if the tumor recurs. Innovative percutaneous treatment including multibipolar “no touch” RF, second generation microwaves or irreversible electroporation will extend indication of percutaneous treatment. Multibipolar RF increases the volume of ablation, second generation microwaves could treat quickly multinodular HCC and irreversible electroporation could treat HCC in high risk locations.