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Peer-reviewedCC BY-NC-NDESMO gastrointestinal oncology

Recent advances in loco-ablative therapies for liver cancers.

  1. 1Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
  2. 2Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China.

Abstract

Background

Hepatocellular carcinoma (HCC) is the most pervasive form of liver cancer worldwide, with its incidence rising due to lifestyle trends. The majority of HCC cases cannot be treated surgically; hence, loco-ablative therapies are required. Classically, radiofrequency ablation (RFA) has been the loco-ablative therapy most often selected for nonresectable HCC. However, due to technological advances and a better understanding of HCC's pathophysiology, new loco-ablative therapies have been developed for HCC. These novel techniques offer an alternative to surgery and RFA depending on each patient's clinical presentation, such as the number and size of nodules. Moreover, they present different benefits and potential clinical complications; therefore, knowledge of available techniques is important to allow clinicians to select the most suitable therapy for their patients.Materials and methods

A narrative review was carried out to summarize the existing loco-ablative therapies for HCC, as well as to investigate emerging loco-ablative therapies for HCC. The benefits, drawbacks, indication for, and mechanism of each technique are outlined.Conclusions

The frontier of locoregional HCC treatment is shifting toward histotripsy and combinations of existing locoregional therapies with immunotherapy. The importance of a multidisciplinary team is highlighted. Nonetheless, there remains a role for surgical resection of HCC and classical locoregional therapies such as RFA, as there is a lack of large-scale randomised controlled trials investigating the role of novel locoregional techniques for treating HCC patients.

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BibTeX
@article{orr2026recent,
  title = {{Recent advances in loco-ablative therapies for liver cancers.}},
  author = {R Orr and B Chan and E Y J Lo and K S H Chok},
  journal = {ESMO gastrointestinal oncology},
  year = {2026},
  month = jun,
  doi = {10.1016/j.esmogo.2026.100354},
  url = {https://europepmc.org/article/MED/42948667},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Recent advances in loco-ablative therapies for liver cancers.
AU  - R Orr
AU  - B Chan
AU  - E Y J Lo
AU  - K S H Chok
PY  - 2026
DA  - 2026/06/24
JO  - ESMO gastrointestinal oncology
DO  - 10.1016/j.esmogo.2026.100354
UR  - https://europepmc.org/article/MED/42948667
AB  - Background  Hepatocellular carcinoma (HCC) is the most pervasive form of liver cancer worldwide, with its incidence rising due to lifestyle trends. The majority of HCC cases cannot be treated surgically; hence, loco-ablative therapies are required. Classically, radiofrequency ablation (RFA) has been the loco-ablative therapy most often selected for nonresectable HCC. However, due to technological advances and a better understanding of HCC's pathophysiology, new loco-ablative therapies have been developed for HCC. These novel techniques offer an alternative to surgery and RFA depending on each patient's clinical presentation, such as the number and size of nodules. Moreover, they present different benefits and potential clinical complications; therefore, knowledge of available techniques is important to allow clinicians to select the most suitable therapy for their patients.Materials and methods  A narrative review was carried out to summarize the existing loco-ablative therapies for HCC, as well as to investigate emerging loco-ablative therapies for HCC. The benefits, drawbacks, indication for, and mechanism of each technique are outlined.Conclusions  The frontier of locoregional HCC treatment is shifting toward histotripsy and combinations of existing locoregional therapies with immunotherapy. The importance of a multidisciplinary team is highlighted. Nonetheless, there remains a role for surgical resection of HCC and classical locoregional therapies such as RFA, as there is a lack of large-scale randomised controlled trials investigating the role of novel locoregional techniques for treating HCC patients.
SN  - 2949-8198
ER  -