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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Image-guided percutaneous laser ablation for primary and secondary liver tumours

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    1 Draft recommendations

    1.1

    Image-guided percutaneous laser ablation for primary and secondary liver tumours can be used in the NHS while more evidence is generated. It can only be used with special arrangements in place for clinical governance, informed consent and audit.

    1.2

    Clinicians wanting to do image-guided percutaneous laser ablation for primary and secondary liver tumours should:

    • Inform the clinical governance leads in their healthcare organisation.

    • Ensure that people (and their families and carers as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.

    • Take account of NICE's advice on shared decision making, including NICE's information for the public.

    • Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).

    • Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

    1.3

    Healthcare organisations should:

    • Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.

    • Regularly review data on outcomes and safety for this procedure.

    1.4

    Patient selection should be done by a multidisciplinary team experienced in managing primary and secondary liver tumours.

    More research

    1.5

    More research is needed on:

    • patient selection

    • ablation success

    • longer-term outcomes.

    Why the committee made these recommendations

    The evidence raises no major safety concerns. There is some evidence that the procedure can destroy tumours (tumour ablation), but more evidence is needed on longer-term outcomes. The procedure may benefit particular groups of patients, but more evidence is needed to confirm this.