The Emerging Role of Ablation in the Treatment of Primary and Metastatic Cancer of the Liver

The traditional management of resectable colorectal liver metastases (CLMs) includes systemic therapy and curative (R0) surgery. Hepatocellular carcinoma (HCC) treatment options include R0 surgery, liver transplantation (LT), chemoembolisation, and targeted chemotherapy. Ablative techniques (radiofrequency ablation and microwave ablation) targeting liver lesions were until recently considered suitable only for patients deemed unfit for surgical resection. However, over time, data suggesting the non-inferior results of radical (A0) ablation compared with radical surgery have started to emerge. Given the lower complication rate of ablative therapies compared with surgery, the question arises as to whether ablation has the potential to replace the role of surgery in the treatment of HCC and colorectal cancer metastases to the liver. In this review, we address the current evidence on the topic and its possible impact on future clinical practice.