Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis
Background: Microwave ablation (MWA) has several advantages over radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). We aimed to compare the efficacy and safety of MWA with those of RFA for HCC from the perspectives of percutaneous and laparoscopic approaches. Methods:...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-01-01
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| Series: | International Journal of Hyperthermia |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/02656736.2018.1562571 |
| _version_ | 1818195833277906944 |
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| author | Wencheng Tan Qiwen Deng Shiyong Lin Yuhong Wang Guoliang Xu |
| author_facet | Wencheng Tan Qiwen Deng Shiyong Lin Yuhong Wang Guoliang Xu |
| author_sort | Wencheng Tan |
| collection | DOAJ |
| description | Background: Microwave ablation (MWA) has several advantages over radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). We aimed to compare the efficacy and safety of MWA with those of RFA for HCC from the perspectives of percutaneous and laparoscopic approaches. Methods: PubMed/MEDLINE, Embase, the Cochrane library, and China Biology Medicine databases were searched. Studies comparing the efficacy and safety of MWA with those of RFA in patients with HCC were considered eligible. Complete ablation (CA), local recurrence (LR), disease-free survival (DFS), overall survival (OS), and the major complication rate were compared between MWA and RFA. Results: Four randomized controlled trials and 10 cohort studies were included. For percutaneous ablation, no significant difference was found between MWA and RFA regarding CA, LR, DFS, OS, and the major complication rate. A subgroup analysis of tumors measuring ≥3 cm revealed no difference in CA and LR for percutaneous ablation. For laparoscopic ablation, a significantly lower LR rate and a non-significant trend toward a higher major complication rate were observed for the MWA group (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.16–4.02, p = .01 for LR; OR 0.21, 95% CI 0.04–1.03, p = .05 for major complication rate). CA, DFS, and OS were similar between the two groups. Conclusions: Percutaneous (P)-MWA had similar therapeutic effects compared with P-RFA for HCC. Patients undergoing laparoscopic MWA had a lower LR rate; however, their major complication rate appeared to be higher. The superiority of MWA over RFA remains unclear and needs to be confirmed by high-quality evidence. |
| first_indexed | 2024-12-12T01:24:28Z |
| format | Article |
| id | doaj.art-0de7bb89272a47068e2a422f6df0ac10 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-12-12T01:24:28Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-0de7bb89272a47068e2a422f6df0ac102022-12-22T00:43:07ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572019-01-0136126327110.1080/02656736.2018.15625711562571Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysisWencheng Tan0Qiwen Deng1Shiyong Lin2Yuhong Wang3Guoliang Xu4Sun Yat-sen University Cancer Centerthe First Affiliated Hospital Sun Yat-sen UniversitySun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterSun Yat-sen University Cancer CenterBackground: Microwave ablation (MWA) has several advantages over radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). We aimed to compare the efficacy and safety of MWA with those of RFA for HCC from the perspectives of percutaneous and laparoscopic approaches. Methods: PubMed/MEDLINE, Embase, the Cochrane library, and China Biology Medicine databases were searched. Studies comparing the efficacy and safety of MWA with those of RFA in patients with HCC were considered eligible. Complete ablation (CA), local recurrence (LR), disease-free survival (DFS), overall survival (OS), and the major complication rate were compared between MWA and RFA. Results: Four randomized controlled trials and 10 cohort studies were included. For percutaneous ablation, no significant difference was found between MWA and RFA regarding CA, LR, DFS, OS, and the major complication rate. A subgroup analysis of tumors measuring ≥3 cm revealed no difference in CA and LR for percutaneous ablation. For laparoscopic ablation, a significantly lower LR rate and a non-significant trend toward a higher major complication rate were observed for the MWA group (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.16–4.02, p = .01 for LR; OR 0.21, 95% CI 0.04–1.03, p = .05 for major complication rate). CA, DFS, and OS were similar between the two groups. Conclusions: Percutaneous (P)-MWA had similar therapeutic effects compared with P-RFA for HCC. Patients undergoing laparoscopic MWA had a lower LR rate; however, their major complication rate appeared to be higher. The superiority of MWA over RFA remains unclear and needs to be confirmed by high-quality evidence.http://dx.doi.org/10.1080/02656736.2018.1562571microwave ablationradiofrequency ablationhepatocellular carcinomapercutaneouslaparoscopic |
| spellingShingle | Wencheng Tan Qiwen Deng Shiyong Lin Yuhong Wang Guoliang Xu Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis International Journal of Hyperthermia microwave ablation radiofrequency ablation hepatocellular carcinoma percutaneous laparoscopic |
| title | Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis |
| title_full | Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis |
| title_fullStr | Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis |
| title_full_unstemmed | Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis |
| title_short | Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis |
| title_sort | comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma a systematic review and meta analysis |
| topic | microwave ablation radiofrequency ablation hepatocellular carcinoma percutaneous laparoscopic |
| url | http://dx.doi.org/10.1080/02656736.2018.1562571 |
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