During the last years, many local and regional techniques have been introduced, helping,
together with surgery, to treat the hepatocellular carcinoma, and contributing to an
important improvement of disease free survival and overall survival of patients affected by
this disease. These techniques, suitable also for metastatic lesions, can be performed as
exclusive ones or following surgery, and help controlling tumor progression even when it is
over any possible surgical approach.
Local and regional therapies can be divided into two groups: in the first one we can consider
the techniques using heat to obtain their effect, in the second one we consider those using
chemotherapic drugs to obtain necrosis of the neoplastic tissue. Necrosis can be obtained
through the energy produced by radiofrequency probes, through the alcohol or acetic acid
injection or through the injection of embolyzing substances, also together with
chemotherapic drugs, into the hepatic artery. Last but not least, the injection of yttrium
labeled microspheres is available. These are injected into the hepatic artery and are able to
cytoreduce the tumor through a local irradiation.
