The challenge of liver tumors for interventional oncology: past, present and future Special Feature: Editorial

This BJR special feature was planned for our readers to understand the role of interventional oncology (IO) for liver tumors, utilise it appropriately in daily practice, and to look at the future of IO. This collection starts with the fundamental groundwork of IO by focusing on the history of IO for liver tumours, which is described in a Review by Solbiati and Arai. ¹ With the history as context, the next Review in this collection delves into the current guidelines for the treatment of HCC throughout the world—reflecting different regional approaches, but also common cornerstones in the management of HCC, which is described by Garcia-Monaco et al. ²

The next set of Reviews seek to demonstrate the evidence basis behind the current role IO plays in the treatment of liver metastases, in two articles “Role of interventional oncology for treatment of liver metastases: evidence-based best practice” ³ by Stavroski and Pereira and, displaying a rather recently developed field, “Oligometastatic disease in the liver: the role of interventional oncology” by Adnan et al. ⁴ The next article in this special feature entitled “The role of interventional oncology in hepatocellular carcinoma: future best practice beyond current guidelines” by Goyal et al seeks to combine the current knowledge and describe the best practices beyond the guidelines. ⁵ We do however realise that there have also been huge advances in systemic therapies over the past 5 years. New treatment options have been developed mainly with the introduction of immuno- and antiangiogenetic therapies. As such, a Review by Jost et al. seeks to describe the relationship between IO and recent systemic therapies in “Synergizing liver systemic treatments with interventional oncology: friend or foe?”. ⁶ However, as we read about in the history of IO article, we know that our specialty was born out of the innovative spirit. As innovators, in IO we are not satisfied with the status quo, and continually strive to develop new treatment approaches and technologies to better care for our patients. These new treatment approaches are highlighted in a Review by Breuer et al. entitled “Interventional oncology: new techniques and new devices”. ⁷

And finally, we end this BJR special feature with two Commentaries that include extreme IO cases from the experts to inspire us, and these are ”Transarterial chemoembolization for hepatocellular carcinoma with vascular invasion” ⁸ by Miyayama et al., and “Treating the most challenging cases of liver metastases” ⁹ by de Baere at al. These two Commentaries are not meant to promote practice beyond guidelines, but rather should remind us that there is a small percentage of patients who do not fit into guidelines and may need individual treatment approaches in centres with highly specialised expertise.

This BJR special feature will take you on a journey from the pioneers to the new frontiers of IO for liver tumors. We hope that you will enjoy reading this collection and that this will serve as an inspiration for your daily practice.