Nanoknife and hepatic embolization for colorectal cancer liver metastases

Effective techniques for local management of unresectable colorectal liver metastases are important tools for a substantial number of patients. Novel approaches and technical improvement of older techniques have been developed to target liver lesions, both in the combined-modality and salvage settings. Irreversible electroporation is a non-thermal technique and can be safely delivered to lesions in the margins of blood vessels, with low risk of vascular disruption. Hepatic embolization consists of selectively treating a hepatic tumor, via its nutrient arterial supply, with one of the following technical variations: bland embolization, chemoembolization, or radioembolization. These techniques have achieved locoregional disease control activity that ultimately may translate into survival gains. Both modalities should be considered as an option for selected patients with colorectal cancer liver metastases.