Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, and is most commonly found in the setting of liver cirrhosis. Treatment of HCC must consider both the tumors present, as well as the remaining dysfunctional liver that both hinders treatment and can produce additional HCC over time. Ablation is an evolving part of the multimodality treatment approach to HCC that can effectively destroy tumors while preserving surrounding liver parenchyma. New technologies have

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... ade ablation an indispensable tool in the treatment of all stages of HCC. This review presents the history, present technologies and future potential of ablation in the treatment of HCC. Hepatic tumor ablation continues to evolve toward providing maximum ablation effect with minimal damage to surrounding tissue. Percutaneous ethanol injection is a less commonly used ablation modality that is beneficial for lesions located near structures/vessels to be preserved. Radiofrequency and microwave ablation are the most commonly employed ablation modalities, and can be used in open surgery, minimally invasive surgery and percutaneous image-guided ablations. Irreversible electroporation is an emerging nonthermal ablation technology that preserves tissue architecture. Other emerging ablation modalities, such as high-frequency focused ultrasound, offer a means of performing thermal ablation without percutaneous insult.