Use of Microwave and Radiofrequency Liver Ablation for the Surgical Treatment of Hepatocellular Carcinoma or Colorectal Liver Metastases Less Than 5 cm

Publication Date: November 13, 2023
Last Updated: November 15, 2023

Summary of Recommendations

The panel suggests MWA and RFA are both safe and feasible. There was insufficient evidence to recommend one modality over another in terms of oncologic outcomes. (C, VL)
620
The panel suggests that either ablative approach achieves similar overall outcomes, albeit through distinct patterns. The laparoscopic approach obtained better local control and the percutaneous approach had fewer morbidities while obtaining similar overall 1-year survival. (C, VL)
620

Recommendation Grading

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Overview

Title

Use of Microwave and Radiofrequency Liver Ablation for the Surgical Treatment of Hepatocellular Carcinoma or Colorectal Liver Metastases Less Than 5 cm

Authoring Organization

Publication Month/Year

November 13, 2023

Last Updated Month/Year

December 19, 2023

Document Type

Guideline

Country of Publication

US

Document Objectives

Primary hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) represent the liver’s two most common malignant neoplasms. Liver-directed therapies such as ablation have become part of multidisciplinary therapies despite a paucity of data. Therefore, an expert panel was convened to develop evidence-based recommendations regarding the use of microwave ablation (MWA) and radiofrequency ablation (RFA) for HCC or CRLM less than 5 cm in diameter in patients ineligible for other therapies.

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient, Radiology services, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Treatment, Management

Diseases/Conditions (MeSH)

D008099 - Liver, D008113 - Liver Neoplasms

Keywords

hepatocellular carcinoma, liver cancer, hcc, liver metastases, resectable cancer, liver ablation

Source Citation

Ceppa EP, Collings AT, Abdalla M, Onkendi E, Nelson DW, Ozair A, Miraflor E, Rahman F, Whiteside J, Shah MM, Ayloo S, Dirks R, Kumar SS, Ansari MT, Sucandy I, Ali K, Douglas S, Polanco PM, Vreeland TJ, Buell J, Abou-Setta AM, Awad Z, Kwon CH, Martinie JB, Sbrana F, Pryor A, Slater BJ, Richardson W, Jeyarajah R, Alseidi A. SAGES/AHPBA guidelines for the use of microwave and radiofrequency liver ablation for the surgical treatment of hepatocellular carcinoma or colorectal liver metastases less than 5 cm. Surg Endosc. 2023 Nov 13. doi: 10.1007/s00464-023-10468-1. Epub ahead of print. PMID: 37957297.