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Percutaneous microwave ablation versus radiofrequency ablation of hepatocellular carcinoma: a meta-analysis of randomized controlled trials

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) are well-validated interventions for hepatocellular carcinoma (HCC). The purpose of this study was to compare their safety and efficacy through a meta-analysis of randomized controlled trials (RCT).

Methods

MEDLINE, Pubmed, and the Cochrane Library were queried up to September 2020 using the terms “microwave”, “radiofrequency”, “hepatocellular”, and “randomized”. Only RCTs investigating MWA versus RFA for HCC were included. Baseline study characteristics, complete ablation rate, ablation time, overall survival, local recurrence, and complication rates were investigated.

Results

Among the five original studies included, a total of 413 and 431 patients were treated with RFA and MWA, respectively. All studies focused on very early and early-stage HCC only (Barcelona Clinic Liver Cancer Stage 0 and A). No statistical significance was observed in terms of complete ablation rate (96.7 vs 96.9%, p = 0.882), overall survival (6 month: 95.7 vs 100%, p = 0.492; 1 year: 91.9 vs 94.1%, p = 0.264; 3 year: 77.5 vs 78.4%, p = 0.905), recurrence-free survival (6 month: 99.1 vs 99.7%, p = 0.717; 1 year: 94.6 vs 93.9%, p = 0.675; 3 year: 76.8 vs 77.1%, p = 0.935), and complication rates (p > 0.05 in all types). The mean ablation time of MWA was significantly shorter than RFA (26.9 vs 14.1 min, p < 0.001).

Conclusion

For very early and early-stage HCC, RFA and MWA are equally safe and effective, though the former is associated with a longer ablation time.

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Availability of data and material

The present study is a meta-analysis of publish articles.

Abbreviations

CA:

Complete ablation rate

HCC:

Hepatocellular carcinoma

MWA:

Microwave ablation

OS:

Overall survival

RCT:

Randomized controlled trial

RFA:

Radiofrequency ablation

RFS:

Recurrence-free survival

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Authors and Affiliations

  1. Department of General Surgery, Cleveland Clinic Florida, Weston, FL, USA

    Qian Yu

  2. Ben&May Department of Cancer Research, University of Chicago, Chicago, IL, USA

    Chenyu Liu

  3. Department of Radiology, University of Chicago, Chicago, IL, USA

    Rakesh Navuluri & Osman Ahmed

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  1. Qian Yu
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  2. Chenyu Liu
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  3. Rakesh Navuluri
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  4. Osman Ahmed
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Yu, Q., Liu, C., Navuluri, R. et al. Percutaneous microwave ablation versus radiofrequency ablation of hepatocellular carcinoma: a meta-analysis of randomized controlled trials. Abdom Radiol 46, 4467–4475 (2021). https://doi.org/10.1007/s00261-021-03080-1

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