Hepatocellular carcinoma (HCC) is one of the most common
cancers worldwide. Although surgical resection and
liver transplantation are the curative treatments, many of HCC patients do not qualify for these curative
therapies at the presentation. Thus, ablation
therapies are currently important modalities in HCC treatment. Among currently available ablation
therapies,
cryoablation (ie,
cryotherapy) is a novel local therapeutic modality. However,
cryoablation has not been widely used as one of ablation
therapies for HCC, because of historical concerns about risk of
bleeding when
cryotherapy is delivered by early generation of the
argon-
helium device. Nevertheless, with technological advances and increased clinical experience in the past decade, clinical application of
cryoablation for HCC management has significantly increased. Accumulating data have demonstrated that
cryoablation is highly effective in local
tumor control with well-acceptable safety profile, and the overall survival is comparable with that of
radiofrequency ablation in patients with
tumors <5 cm. Compared with
radiofrequency ablation and other thermal-based modalities,
cryoablation has several advantages, such as the ability to produce larger and precise zones of ablation. This article systemically reviews the advances in clinical application of
cryoablation therapy for HCC, including the related mechanisms and technology, clinical indications, efficacy and safety profiles, and future research directions.