Radiofrequency Ablation For Small Hepatocellular Carcinoma

This book provides a comprehensive guide to the treatment of small hepatocellular carcinoma (sHCC) using a minimally invasive technique: radiofrequency ablation (RFA). RFA has emerged as a new treatment modality and become the main modality of locoregional therapy. Extensive clinical research indicates that RFA is as effective as surgical resection for sHCC, and it has the advantage of being less invasive. However, the outcomes after RFA are largely dependent on the operators’ experience- known as the “learning curve”. This book presents the characteristics of sHCC and discusses why sHCC is the best candidate for RFA. Then it introduces all the commercially available RFA systems, and their working principles, advantages, disadvantages and so on. It goes on to demonstrate how to perform RFA under the guidance of ultrasound, CT, laparoscopy, or during open operation. Finally, it discusses the radiologic assessment and follow‐up after RFA, as well as adjuvant therapies and clinical trials on RFA. The authors are experts from the fields of pathology, radiology, surgery, and gastroenterology, as well as manufacturers. With this book, readers gain have a clear idea of when and how to do RFA. It aims to standardize and generalize the procedure of RFA, which will be very helpful in improving the outcome of RFA for sHCC.

A comprehensive and up-to-date overview of the role of diagnostic and interventional radiology in respect of liver malignancies. Following background chapters on anatomy, epidemiology, and clinicopathologic features, each of the diagnostic imaging techniques is carefully appraised, focusing on new developments in equipment and contrast agents. The interventional therapeutic approaches to primary and secondary hepatic malignancies are then discussed in depth, as well as such special topics as liver tumors in children and hepatic transplantation. Written by leading experts from around the world, this will prove to be an indispensable source of information for both clinicians and researchers.

This book provides a comprehensive overview of the current limitations and unmet needs in Hepatocellular Carcinoma (HCC) diagnosis, treatment, and prevention. It also provides newly emerging concepts, approaches, and technologies to address challenges. Topics covered include changing landscape of HCC etiologies in association with health disparities, framework of clinical management algorithm, new and experimental modalities of HCC diagnosis and prognostication, multidisciplinary treatment options including rapidly evolving molecular targeted therapies and immune therapies, multi-omics molecular characterization, and clinically relevant experimental models. The book is intended to assist collaboration between the diverse disciplines and facilitate forward and reverse translation between basic and clinical research by providing a comprehensive overview of relevant areas, covering epidemiological trend and population-level patient management strategies, new diagnostic and prognostic tools, recent advances in the standard care and novel therapeutic approaches, and new concepts in pathogenesis and experimental approaches and tools, by experts and opinion leaders in their respective fields. By thoroughly and concisely covering whole aspects of HCC care, Hepatocellular Carcinoma serves as a valuable reference for multidisciplinary readers, and promotes the development of personalized precision care strategies that lead to substantial improvement of disease burden and patient prognosis in HCC.

There is an enormous sense of excitement in the communities of cancer research and cancer care as we move into the middle third of the ?rst decade of the 21st century. For the ?rst time,there is a true sense of c- ?dence that the tools provided by the human genome project will enable cancer researchers to crack the code of genomic abnormalities that allow tumor cells to live within the body and provide highly speci?c, virtually non-toxic therapies for the eradication,or at least ?rm control of human cancers. There is also good reason to hope that these same lines of inquiry will yield better tests for screening, early detection, and prev- tion of progression beyond curability. While these developments provide a legitimate basis for much op- mism, many patients will continue to develop cancers and suffer from their debilitating effects, even as research moves ahead. For these in- viduals, it is imperative that the cancer ?eld make the best possible use of the tools available to provide present day cancer patients with the best chances for cure, effective palliation, or, at the very least, relief from symptoms caused by acute intercurrent complications of cancer. A modality that has emerged as a very useful approach to at least some of these goals is tumor ablation by the use of physical or physiochemical approaches.

Cancer is one of the major health problems of our time and liver cancer is responsible for over one million deaths per year world-wide, making it the fourth most common cause of death from cancer. Surgical resection of the tumour(s) is the treatment of choice and offers the only chance of prolonged survival. Yet the best attempts are often frustrated by either advanced or co-existent disease that renders the patient non-resectable. This book tackles the many options available to doctors and patients in an attempt to combat this desperate disease.

Modern sonography makes possible the detection of small and subtle changes in the normal echo pattern. These may represent significant pathological changes which can not al ways be fully revealed by the echo pattern alone. There is, therefore, an increasing need for the supplement of the ultra sonically guided percutaneous puncture, which can be per formed with great accuracy and with virtually no risk. Also, ultrasonically guided puncture has proven invaluable for a wide variety of therapeutic purposes. The first percutaneous puncture guided by ultrasonic scanning using a specifically designed transducer was per formed in 1969 at the ultrasonic laboratory in Gentofte, now Herlev, Hospital, Copenhagen. The idea was based on a punc ture transducer described and used by Kratochwill for punc ture under the guidance of the ultrasonic A-presentation tech nique. The development in the field formed the basis of the First International Conference on Ultrasonically Guided Puncture at Herlev Hospital in 1978 sponsored by The Danish Society of Diagnostic Ultrasound. The knowledge and experience of the speakers at that conference was compiled in the book "Ultrasonically Guided Puncture Technique" published in 1980. Since then the Society has sponsored a conference at the same place in 1980 and 1983, the latest conference being termed "Third International Conference on lnterventional Ultrasound".

Radiofrequency Ablation of Cancer: Current Indications, Techniques and Outcomes discusses the principles and techniques of safe usage of radiofrequency current for the treatment of malignancies. Throughout the text, indications and outcomes data are stressed. Edited and authored by pioneers in the field, the book features extensive discussion of RFA for hepatic tumors, including treatment of liver metastases from colorectal cancer, combined modality therapy for liver metastases, treatment of hepatocellular carcinoma with RFA, laparoscopic RFA, percutaneous RFA, and hepatic metastases from neuroendocrine tumors. In addition, chapters consider the emerging role of RFA in the management of primary breast cancer, primary bone tumors as well as metastatic bone tumors, renal tumors, and lung tumors. The principles and instrumentation as well as the imaging aspects of RFA are presented with comprehensive chapters on ultrasound, MRI, PET and CT by leaders in the field. Complemented by 90 illustrations, this text is the gold standard reference on the use of RFA in treating a wide variety of malignant processes. It will serve as a valuable reference for all physicians engaged in the care of cancer patients.