Radiofrequency Ablation for Recurrent Pleural Mesothelioma

Our plain-English summary of Radiofrequency Ablation for Recurrent Pleural Mesothelioma, by H. Kodama, K. Kuribayashi, H. Takaki, et al (Cancers, 2026).

The study

• Authors: H. Kodama, K. Kuribayashi, H. Takaki, K. Matsuda, T. Shinkai, R. Wada, A. Ogasawara, M. Hashimoto, D. Fujimoto, T. Minami, S. Funaki, T. Kijima, K. Yamakado
• Journal: Cancers
• Published: 2026;18(3)
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background/Objectives: Pleural mesothelioma (PM) frequently recurs despite multimodal therapy. Here, we aimed to retrospectively evaluate the safety and potential clinical benefit of radiofrequency ablation (RFA) for recurrent PM. Methods: Fourteen consecutive patients underwent CT-guided RFA between July 2019 and June 2025. The cohort comprised 13 men and 1 woman, with a median age of 69 (range, 54-77) years. All patients had previously received systemic therapy, and 12 had undergone surgery. Seven patients (50%) presented with multiple lesions, and 25 tumors (median diameter 1.8 cm; range, 0.5-7.0 cm) were treated in 23 sessions. Outcomes assessed were local tumor control, complications, and survival. Local progression and overall survival were estimated using Kaplan-Meier analysis. Adverse events were classified according to the Society of Interventional Radiology guidelines. Results: Technical success was achieved in all sessions. Two tumors showed local recurrence, corresponding to 1- and 2-year local progression rates of 10.6%. Seven patients showed distant metastases, most of whom subsequently received systemic therapy. Three patients died, two from disease progression and one from treatment-related gastrointestinal perforation during therapy for an unrelated cancer. The overall survival rates were 100%, 100%, and 60% at 1, 3, and 5 years, respectively. Major and minor complications occurred in one case each (4.3%): a refractory skin ulcer and retroperitoneal hematoma, respectively. Conclusions: RFA was technically feasible and generally well tolerated and helped achieve encouraging local control and survival in patients with recurrent PM, warranting further evaluation of RFA as a complementary approach in multimodal treatment strategies.

In plain English

This retrospective study at one Japanese hospital reviewed 14 consecutive patients (13 men, 1 woman; median age 69) whose pleural mesothelioma had returned after earlier treatment. All had received drug (systemic) therapy, and 12 had had surgery. From July 2019 to June 2025 they were treated with radiofrequency ablation, in which a CT-guided electrode heats tumors. In total, 25 tumors were treated in 23 sessions. The article does not report asbestos exposure. All sessions met the authors' definition of technical success. One major complication (a non-healing skin ulcer) and one minor bleed each occurred in 1 of 23 sessions (4.3%); the results describe the bleed as under the skin, the abstract as retroperitoneal. Two of the 25 treated tumors (8.0%) regrew at the treated site. Cancer returned in 7 of the 14 patients, mostly elsewhere in the body. Three patients died. Estimated overall survival was 100% at 3 years and 60% at 5 years. The authors concluded that the treatment appeared feasible, safe and effective. They noted the small, single-center design and called for larger prospective studies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective single-center case series
• Who was studied: 14 consecutive patients with recurrent pleural mesothelioma treated at Hyogo Medical University, Japan, from July 2019 to June 2025. There were 13 men and 1 woman, median age 69 (range 54 to 77). Tumor types were epithelioid in 11, biphasic in 2 and sarcomatoid in 1. All had prior systemic therapy and 12 had prior surgery. In total, 25 tumors were treated: 12 in the chest wall, 11 in the lung and 1 in the liver.
• Exposure: The article does not report asbestos or other exposure. What was studied was a treatment: CT-guided percutaneous radiofrequency ablation, given in 23 sessions. One patient with a 7.0 cm tumor needed three sessions.
• Main results:
  • Technical success was achieved in all 23 sessions (100%).
  • There was one major complication (a refractory skin ulcer) and one minor complication (described in the results section as a small subcutaneous hematoma not requiring intervention). Each was 4.3%, which corresponds to 1 of the 23 sessions.
  • The article's abstract describes the minor complication differently, as a retroperitoneal hematoma.
  • Local progression occurred in 2 of the 25 treated tumors (8.0%). The estimated 1- and 2-year local progression rates were both 10.6%.
  • At a median follow-up of 22 months, 7 of the 14 patients (50%) had recurrence. Two had both local and distant progression, and five had distant metastases alone.
  • Three of the 14 patients (21.4%) died. Two died from tumor progression and one from gastrointestinal perforation during chemotherapy for esophageal carcinoma.
  • Estimated overall survival was 100% at 1 and 3 years and 60% at 5 years. Median overall survival was 5.5 years.
  • Estimated recurrence-free survival was 51.6% at 1 year and 25.8% at both 3 and 5 years.
• The authors' conclusion: The authors concluded that radiofrequency ablation appears to be a feasible, safe and effective minimally invasive treatment for recurrent pleural mesothelioma. They stated that larger, prospective, multi-institutional studies are needed.
• Limitations the authors state:
  • The retrospective, single-institution design and small sample size may introduce selection bias.
  • Follow-up length varied, which may have led to late recurrences being underestimated.
  • Treatment may work less well for tumors larger than 3 cm.
  • The sample was too small to formally compare outcomes by prior surgery or prior radiotherapy.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Multimodal Therapy, Systemic Therapy, Overall Survival, Disease Progression.

Related studies

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• Cytoreductive Surgical Treatment of Pleural Mesothelioma in a Porcine Model Using Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) and Radiofrequency Ablation (RFA) — M. Costa, C. Fernandes, et al. (2022)
• Response to Immune Checkpoint Inhibitor Therapy in Patients with Unresectable Recurrent Malignant Pleural Mesothelioma Shown by FDG-PET and CT — K. Kitajima, M. Maruyama, et al. (2021)
• Intrathoracic chemo-thermotherapy with radiofrequency waves after extrapleural pneumonectomy for malignant pleural mesothelioma — T. Tokunaga, M. Higashiyama, et al. (2011)
• Laser ablation inductively coupled plasma mass spectrometry as a novel clinical imaging tool to detect asbestos fibres in malignant mesothelioma — O.M. Voloaca, C.J. Greenhalgh, et al. (2020)
• Ablation mechanism of polymer layered silicate nanocomposite heat shield — A.R. Bahramian, M. Kokabi (2009)

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