International multisociety Delphi consensus for liver tumour thermal ablation: procedural and practice standards.

Thermal ablation offers a safer, less invasive, and more cost-effective curative-intent treatment for selected patients with primary and metastatic liver tumours than surgery; when done with appropriate technique, ablation can deliver similar oncological outcomes. However, effectiveness in routine practice varies because structured training, planning, and procedural governance remain scarce. These international multidisciplinary, multi-society guidelines-formally endorsed by the European Society of Surgical Oncology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology-define key domains contributing to procedural difficulty and practice variation in liver tumour thermal ablation. A Delphi consensus initiative held in Innsbruck, Austria, engaged 72 experts across three iterative rounds of scoring across 135 statements grouped into five domains: credentialing, indications, approach, procedural factors, and safety measures. Consensus was achieved for 94 (70%) of 135 statements. The least invasive route-typically percutaneous-should be prioritised, and margin adequacy was reaffirmed as the principal technical goal. Procedural difficulty was considered context-dependent, shaped by tumour factors, institutional infrastructure, and operator experience. Organ displacement techniques were endorsed to maintain safety and expand treatable indications. Complex ablations should be done by experienced operators (more than 100 previous cases), with programmes underpinned by structured training, multidisciplinary team participation, and routine audit. Future efforts should develop and validate practical tools such as difficulty scoring systems, standardised procedural reporting templates, and comprehensive training curricula to improve consistency, standardisation, and clinical outcomes globally.

Authors

Institutions

Publication Details

Journal
Open Access CRIS of the University of Bern
Published
2026-05-01
DOI
https://doi.org/10.48620/97427
Primary Topic
Hepatocellular Carcinoma Treatment and Prognosis
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

International multisociety Delphi consensus for liver tumour thermal ablation: procedural and practice standards.

David J. Breen, William S. Rilling, B. Edwin, Rosario Francesco Grasso et al.
Open Access CRIS of the University of Bern
Hepatocellular Carcinoma Treatment and Prognosis
article

International multisociety Delphi consensus for liver tumour thermal ablation: procedural and practice standards.

David J. Breen, William S. Rilling, B. Edwin, Rosario Francesco Grasso, Peter Schullian, Andreas Mahnken, Rodrigo Gobbo Garcia, Jan van der Meulen, Marco Calandri, Justin P. McWilliams, Edward W. Johnston, Bradford J. Wood, Alexander Kupferthaler, Sarah B. White, Philipp Wiggermann, Christiaan G. Overduin, Susan van der Lei, Paul B. Shyn, Manuel Maglione, Reto Bale, Ronald S. Arellano, Lukas Luerken, Anthony G. Ryan, Marie Beermann, Robbert S. Puijk, Marco van Strijen, Constantinos T. Sofocleous, Gregor Laimer, Anja Lachenmayer, Jacob Freedman, Lukas Philipp Beyer, Alban Denys, Iwan Paolucci, Trygve Syversveen, Dimitrios Filippiadis, MARCOS DE MENEZES, Sjoerd FM Jenniskens, Mariano Gimenez, Simeon J S Ruiter, Charles C-W Lin, Maarten L J Smits, Martijn R Meijerink, Franco Orsi, Nicos Fotiadis, Ming-Chih Chern, Bruno C Odisio, Thomas K Helmberger, Åsmund A Fretland, Yuman Fong, Mark C Burgmans, Tze M Wah, Vlasios Sotirchos, Ajith K Siriwardena, Hyunchul Rhim, S Nahum Goldberg, Pascale Tinguely, Uei Pua, Jeong Min Lee, Ronald M van Dam, Stefan Stättner, Philippe L Pereira, Ping Liang, Roberto Iezzi, Govindarajan Narayanan, Muneeb Ahmed, Luigi Solbiati, Lambros Tselikas, Pim Hendriks, Laura Crocetti, Fred T Lee, Thomas J Vogl, Christiaan van der Leij, Jean-Nicolas Vauthey
article en

Abstract

Thermal ablation offers a safer, less invasive, and more cost-effective curative-intent treatment for selected patients with primary and metastatic liver tumours than surgery; when done with appropriate technique, ablation can deliver similar oncological outcomes. However, effectiveness in routine practice varies because structured training, planning, and procedural governance remain scarce. These international multidisciplinary, multi-society guidelines-formally endorsed by the European Society of Surgical Oncology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology-define key domains contributing to procedural difficulty and practice variation in liver tumour thermal ablation. A Delphi consensus initiative held in Innsbruck, Austria, engaged 72 experts across three iterative rounds of scoring across 135 statements grouped into five domains: credentialing, indications, approach, procedural factors, and safety measures. Consensus was achieved for 94 (70%) of 135 statements. The least invasive route-typically percutaneous-should be prioritised, and margin adequacy was reaffirmed as the principal technical goal. Procedural difficulty was considered context-dependent, shaped by tumour factors, institutional infrastructure, and operator experience. Organ displacement techniques were endorsed to maintain safety and expand treatable indications. Complex ablations should be done by experienced operators (more than 100 previous cases), with programmes underpinned by structured training, multidisciplinary team participation, and routine audit. Future efforts should develop and validate practical tools such as difficulty scoring systems, standardised procedural reporting templates, and comprehensive training curricula to improve consistency, standardisation, and clinical outcomes globally.

Open Access CRIS of the University of Bern
Tracer Technologies (United States) (US)
Industry, innovation and infrastructure
Openalex Percentile: Top 8%
Hepatocellular Carcinoma Treatment and Prognosis
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.