Percutaneous Ablation for Metastatic Liver Cancer

Liver metastases are associated with significant morbidity and mortality if left untreated. Depending on the primary tumor type, the distribution and extent of metastatic disease, patients may be eligible for surgical or locoregional treatments, including percutaneous ablation. Multiple studies, primarily focused on the treatment of colorectal cancer liver metastases, have demonstrated a survival benefit for patients undergoing resection and/or ablation. Despite advanced surgical techniques increasing the percentage of patients eligible for surgery, most patients have unresectable disease or are poor surgical candidates at presentation. For many of these patients, ablation may still be offered resulting in local disease control and prolonged survival, especially when combined with systemic chemotherapy. With careful patient selection and adequate minimum ablation margins (at least 5 mm, ideally above 10 mm), local tumor recurrence rates remain low and are comparable to surgery. The available evidence and outcomes following ablation of the most frequently encountered types of liver metastases in clinical practice are reviewed. Patient selection, ablative modalities, complications, and follow-up considerations are also discussed.