Peer-review started: August 2, 2016
First decision: September 28, 2016
Revised: December 23, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: March 28, 2017
Processing time: 235 Days and 20.1 Hours
Radiofrequency ablation (RFA) is currently the most popular and used ablation modality for the treatment of non surgical patients with primary and secondary liver tumors, but in the last years microwave ablation (MWA) is being technically improved and widely rediscovered for clinical use. Laser thermal ablation (LTA) is by far less investigated and used than RFA and MWA, but the available data on its effectiveness and safety are quite good and comparable to those of RFA and MWA. All the three hyperthermia-based ablative techniques, when performed by skilled operators, can successfully treat all liver tumors eligible for thermal ablation, and to date in most centers of interventional oncology or interventional radiology the choice of the technique usually depends on the physician’s preference and experience, or technical availability. However, RFA, MWA, and LTA have peculiar advantages and limitations that can make each of them more suitable than the other ones to treat patients and tumors with different characteristics. When all the three thermal ablation techniques are available, the choice among RFA, MWA, and LTA should be guided by their advantages and disadvantages, number, size, and location of the liver nodules, and cost-saving considerations, in order to give patients the best treatment option.
Core tip: Radiofrequency ablation, microwave ablation, and laser thermal ablation, when performed by skilled operators, can successfully treat all liver tumors eligible for thermal ablation. However, each of them has peculiar advantages and limitations that can make one technique more suitable than the other ones to treat patients and tumors with different characteristics. When all the three techniques are available, the choice should be guided by their advantages and disadvantages, number, size and location of the liver nodules, and cost-saving considerations, in order to give patients the best treatment option.