Abstract

According to updated BCLC guideline, radiofrequency ablation (RFA) is now accepted as a standard treatment for hepatocellular carcinomas (HCCs) smaller than 2 cm in diameter in patients who are not considered for liver transplantation. This is because of acceptable local tumor control and survival gain of RFA for small HCCs compared to those of surgical resection. However, for RFA to be a standard treatment of small HCCs, not only expertise of operator but also optimal guiding and ablation techniques such as fusion imaging, contrast-enhanced ultrasonography, artificial ascites, and switching monopolar RFA using multiple electrodes are necessary. Since RFA and surgical resection are equally effective for very early stage HCC; tumor location (i.e., central vs. peripheral location, proximity to central bile duct) and individual condition of patients should be taken into consideration for choosing appropriate treatment. Microwave ablation, which is an emerging thermal ablation technique, is expected to play a key role in the local ablation therapy of small HCCs in the near future. However, more evidence and data is required to verify the efficacy of microwave ablation for the treatment of small HCCs.

• Keywords: Radiofrequency ablation;Surgery;Hepatocellular carcinoma