Percutaneous thermal ablation shows that its 90-day mortality rate is nearly zero, and its major complication rate is only about 3%, which again shows that this treatment modality has a high safety profile for treating small malignant liver tumors. With the advancement of minimally invasive oncologic therapies, percutaneous thermal ablation (PTA) has emerged as a widely accepted treatment modality for treating small malignant liver tumors. However, there is a wide variation in complication rates that has necessitated an update of this complication rate. A recent study was published in the Radiology journal by Gary D. and colleagues.The present systematic review and single-proportion meta-analysis aimed to assess the safety of PTA in MGLTs by using information from three databases: Cochrane, MEDLINE, and Embase. All studies that were included in this systematic review are prospective randomized trials and cohort studies conducted between January 2007 and September 2022.The present analysis is based on patients who have undergone radiofrequency or microwave ablation for a maximum of three tumors in the liver that are ≤5 cm in size and have a follow-up period of at least 90 days. The presence of both tumor types and ablation modalities facilitated a comparative evaluation of complication rates in different clinical situations.The main outcomes of interest were major adverse events, defined as Society of Interventional Radiology grades C to E, and 90-day procedure-related mortality. Random effects models were used to calculate the pooled proportion of complication rates, given the heterogeneity of study populations.Key findings:A total of 49 studies, including 4,149 patients and 4,636 ablations, were included in the analysis.The pooled proportion of major adverse events was 3.0% (86 of 3,149 patients; 95% CI: 2.50-3.67; I² = 0%).The 90-day procedure-related mortality rate was 0.01% (1 of 4,149 patients; 95% CI: 0.007-0.014).The proportion of patients experiencing adverse events was similar between radiofrequency ablation (3.21%) and microwave ablation (2.65%; P = 0.41).There was no significant difference in complication rates between patients with hepatocellular carcinoma (2.94%)Percutaneous thermal ablation for malignant hepatic tumors has a mortality rate of near zero at 90 days, and a major complication rate of about 3%, thus proving it to be a safe and effective technique.Reference:Doppelt, G., Occéan, B.-V., Fabbro-Peray, P., Haefliger, L., Tardieu, L., Schembri, V., Minier, C., Hermida, M., Pierredon Foulongne, M. A., Belgour, A., Frandon, J., Escal, L., Allimant, C., Piron, L., & Guiu, B. (2026). The safety standards for liver Percutaneous thermal ablation: A meta-analysis of adverse events over 15 years. Radiology, 318(3), e251517. https://doi.org/10.1148/radiol.251517