Published: 2021-11-24

Role of percutaneous thermal ablation in cancer treatment

Doha Jamal Ahmad, Amal Yahea Alyami, Abdullah Ahmed Alasker, Kholoud Bakur Fallatah, Reshan Mane AlReshan, Meshari Tael Althuwaybi, Fawzyah Salem Alhabes, Bader Bandar Alnefaie, Ahmed Mosa Alzahrany, Hiaallah Ali Alshehri, Saeed Ahmad Hethwell


The main aim of using thermal ablation strategies is to eliminate the targeted malignant cells within a specific volume. However, it should be noted that some researchers have reported the potential limitations of some of these techniques. On the other hand, more updated investigations indicated that these limitations could be overcome by the adjuvant use of other management modalities as chemotherapy. Many limitations have been reported with the modality, including the prolonged therapeutic time. Therefore, cryoablation and microwave ablation techniques were introduced in the literature as safe and efficacious modalities that overcame the limitations of the radiofrequency technique. Overall, percutaneous thermal ablation is associated with favorable outcomes and should be used in clinical settings due to the various advantages that have been reported for the modality, in addition to being less invasive.


Thermal ablation, Management, Radiofrequency, Microwave ablation, Carcinoma

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Ahmed M, Brace CL, Lee FT, Jr., Goldberg SN. Principles of and advances in percutaneous ablation. Radiology. 2011;258(2):351-69.

Chen Z, Xie H, Hu M. Recent progress in treatment of hepatocellular carcinoma. American journal of cancer research. 2020;10(9):2993-3036.

Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology. 2003;226(2):441-51.

Gervais DA, McGovern FJ, Arellano RS, McDougal WS, Mueller PR. Renal cell carcinoma: clinical experience and technical success with radio-frequency ablation of 42 tumors. Radiology. 2003;226(2):417-24.

Dupuy DE, DiPetrillo T, Gandhi S. Radiofrequency ablation followed by conventional radiotherapy for medically inoperable stage I non-small cell lung cancer. Chest. 2006;129(3):738-45.

Callstrom MR, Atwell TD, Charboneau JW. Painful metastases involving bone: percutaneous image-guided cryoablation--prospective trial interim analysis. Radiology. 2006;241(2):572-80.

Yamakado K, Nakatsuka A, Takaki H. Early-stage hepatocellular carcinoma: radiofrequency ablation combined with chemoembolization versus hepatectomy. Radiology. 2008;247(1):260-6.

Goldberg SN, Kamel IR, Kruskal JB. Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy. AJR American journal of roentgenology. 2002;179(1):93-101.

Jain SK, Dupuy DE, Cardarelli GA, Zheng Z, DiPetrillo TA. Percutaneous radiofrequency ablation of pulmonary malignancies: combined treatment with brachytherapy. AJR American journal of roentgenology. 2003;181(3):711-5.

Lin SM. Local ablation for hepatocellular carcinoma in taiwan. Liver cancer. 2013;2(2):73-83.

Ikeda K, Osaki Y, Nakanishi H. Recent progress in radiofrequency ablation therapy for hepatocellular carcinoma. Oncology. 2014;87:73-7.

Huang Y, Shen Q, Bai HX. Comparison of Radiofrequency Ablation and Hepatic Resection for the Treatment of Hepatocellular Carcinoma 2 cm or Less. Journal of vascular and interventional radiology : JVIR. 2018;29(9):1218-25.

Xu HX, Xie XY, Lu MD. Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation. Clinical radiology. 2004;59(1):53-61.

Zhang L, Wang N, Shen Q, Cheng W, Qian GJ. Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma. PloS one. 2013;8(10):e76119.

Yin T, Li W, Zhao P, Wang Y, Zheng J. Treatment efficacy of CT-guided percutaneous microwave ablation for primary hepatocellular carcinoma. Clinical radiology. 2017;72(2):136-40.

Zhang NN, Lu W, Cheng XJ, Liu JY, Zhou YH, Li F. High-powered microwave ablation of larger hepatocellular carcinoma: evaluation of recurrence rate and factors related to recurrence. Clinical radiology. 2015;70(11):1237-43.

Han J, Fan YC, Wang K. Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2020;99(43):e22703.

Al-Alem I, Pillai K, Akhter J, Chua TC, Morris DL. Heat sink phenomenon of bipolar and monopolar radiofrequency ablation observed using polypropylene tubes for vessel simulation. Surgical innovation. 2014;21(3):269-76.

Lehmann KS, Poch FG, Rieder C. Minimal vascular flows cause strong heat sink effects in hepatic radiofrequency ablation ex vivo. Journal of hepato-biliary-pancreatic sciences. 2016;23(8):508-16.

Lin ZY, Li GL, Chen J, Chen ZW, Chen YP, Lin SZ. Effect of heat sink on the recurrence of small malignant hepatic tumors after radiofrequency ablation. Journal of cancer research and therapeutics. 2016;12:C153-8.

Yin XY, Xie XY, Lu MD. Percutaneous thermal ablation of medium and large hepatocellular carcinoma: long-term outcome and prognostic factors. Cancer. 2009;115(9):1914-23.

Sakaguchi H, Seki S, Tsuji K. Endoscopic thermal ablation therapies for hepatocellular carcinoma: a multi-center study. Hepatology research : the official journal of the Japan Society of Hepatology. 2009;39(1):47-52.

Shibata T, Iimuro Y, Yamamoto Y. Small hepatocellular carcinoma: comparison of radio-frequency ablation and percutaneous microwave coagulation therapy. Radiology. 2002;223(2):331-7.

Facciorusso A, Serviddio G, Muscatiello N. Local ablative treatments for hepatocellular carcinoma: An updated review. World journal of gastrointestinal pharmacology and therapeutics. 2016;7(4):477-89.

Pillai K, Akhter J, Chua TC. Heat sink effect on tumor ablation characteristics as observed in monopolar radiofrequency, bipolar radiofrequency, and microwave, using ex vivo calf liver model. Medicine (Baltimore). 2015;94(9):e580.

El Dib R, Touma NJ, Kapoor A. Cryoablation vs radiofrequency ablation for the treatment of renal cell carcinoma: a meta-analysis of case series studies. BJU international. 2012;110(4):510-6.

Patel HD, Pierorazio PM, Johnson MH. Renal Functional Outcomes after Surgery, Ablation, and Active Surveillance of Localized Renal Tumors: A Systematic Review and Meta-Analysis. Clinical journal of the American Society of Nephrology: CJASN. 2017;12(7):1057-69.

Katsanos K, Mailli L, Krokidis M, McGrath A, Sabharwal T, Adam A. Systematic review and meta-analysis of thermal ablation versus surgical nephrectomy for small renal tumours. Cardiovascular and interventional radiology. 2014;37(2):427-37.

Palussière J, Catena V, Buy X. Percutaneous thermal ablation of lung tumors – Radiofrequency, microwave and cryotherapy: Where are we going? Diagnostic and Interventional Imaging. 2017;98(9):619-25.

Simon CJ, Dupuy DE, DiPetrillo TA. Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients. Radiology. 2007;243(1):268-75.

Beland MD, Wasser EJ, Mayo-Smith WW, Dupuy DE. Primary non–small cell lung cancer: review of frequency, location, and time of recurrence after radiofrequency ablation. Radiology. 2010;254(1):301-7.

Palussiere J, Lagarde P, Aupérin A, Deschamps F, Chomy F, de Baere T. Percutaneous lung thermal ablation of non-surgical clinical N0 non-small cell lung cancer: results of eight years’ experience in 87 patients from two centers. Cardiovascular and interventional radiology. 2015;38(1):160-6.

de Baere T, Tselikas L, Catena V, Buy X, Deschamps F, Palussière J. Percutaneous thermal ablation of primary lung cancer. Diagnostic and Interventional Imaging. 2016;97(10):1019-24.