European Radiology

, Volume 21, Issue 12, pp 2584–2596 | Cite as

Mortality and complication rates of percutaneous ablative techniques for the treatment of liver tumors: a systematic review

  • Luis Calzadilla Bertot
  • Masaya Sato
  • Ryosuke TateishiEmail author
  • Haruhiko Yoshida
  • Kazuhiko Koike



Reported rates of major complications and mortality of radiofrequency ablation (RFA), microwave ablation (MWA) and percutaneous ethanol injection (PEI) for the treatment of liver tumours were substantially heterogeneous among studies. The aim was to analyse the mortality and major complication rates of percutaneous RFA, PEI and MWA.


MEDLINE and EMBASE search from January 1982 to August 2010. Randomised clinical trials and observational studies, age >18, more than 50 patients for each technique analysed, studies reporting mortality and major complications were included. Random effects model was performed, with assessment for heterogeneity and publication bias.


Thirty-four studies including 9531, 1185, and 1442 patients for RFA, MWA, and PEI, respectively were included. For all ablative techniques pooled proportion mortality rate was 0.16% (95% confidence interval [CI], 0.10–0.24). Pooled mortality rate associated with RFA, PEI and MWA was 0.15% (0.08–0.23), 0.59% (0.14–1.3) and 0.23% (0.0–0.58) respectively. Pooled proportion of major complications was 3.29% (2.43–4.28). Major complication rates associated with RFA, MWA, and PEI was 4.1% (3.3–5.1), 4.6% (0.7–11.8) and 2.7% (0.28–7.4) respectively.


Percutaneous RFA, PEI and MWA can be considered safe techniques for the treatment of liver tumours.


Liver neoplasms Ablation techniques Mortality Complications Meta-Analysis 



Hepatocellular carcinoma


Radiofrequency ablation


Percutaneous ethanol injection


Microwave ablation


Confidence interval


Colorectal cancer


Computed tomography


Magnetic resonance imaging


Society of interventional radiology



This work was supported in part by Health Sciences Research Grants of The Ministry of Health, Labour and Welfare of Japan (Research on Hepatitis).The supporters had no role in study design; collection, analysis, interpretation of data; writing of the report or decision to submit the manuscript for publication.


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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Luis Calzadilla Bertot
    • 1
  • Masaya Sato
    • 1
  • Ryosuke Tateishi
    • 1
    Email author
  • Haruhiko Yoshida
    • 1
  • Kazuhiko Koike
    • 1
  1. 1.Department of Gastroenterology, Graduate School of MedicineThe University of TokyoTokyoJapan

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