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Meta-Analysis
. 2020 Nov-Dec;34(6):3421-3429.
doi: 10.21873/invivo.12181.

The (Eternal) Debate on Microwave Ablation Versus Radiofrequency Ablation in BCLC-A Hepatocellular Carcinoma

Angela Dalia Ricci #  1 , Alessandro Rizzo #  2 , Chiara Bonucci  1 , Simona Tavolari  3 , Andrea Palloni  1 , Giorgio Frega  1 , Veronica Mollica  1 , Nastassja Tober  1 , Elena Mazzotta  4 , Cristina Felicani  4 , Carla Serra  4 , Giovanni Brandi  1
Affiliations
Meta-Analysis

The (Eternal) Debate on Microwave Ablation Versus Radiofrequency Ablation in BCLC-A Hepatocellular Carcinoma

Angela Dalia Ricci et al. In Vivo. 2020 Nov-Dec.

Abstract

Background/aim: While percutaneous radiofrequency ablation (RFA) is considered the standard ablative modality for the treatment of early-stage hepatocellular carcinoma (HCC), percutaneous microwave ablation (MWA) is being increasingly used in recent years. We performed a systematic review and meta-analysis to compare percutaneous MWA versus percutaneous RFA in BCLC-A HCC across randomized controlled trials (RCTs).

Patients and methods: Eligible studies included RCTs assessing MWA versus RFA in BCLC-A HCC. Outcomes of interest included: complete ablation (CA) rate, local recurrence (LR) rate, 1-year overall survival (OS) rate, 3-year OS rate and major complications rate.

Results: We retrieved all the relevant RCTs through PubMed/Medline, Cochrane library and EMBASE; five eligible studies involving a total of 794 patients (MWA: 409; RFA: 385) and 1008 nodules of HCC (MWA: 519; RFA: 489) were included in our analysis. No significant differences were found between MWA and RFA regarding CA, LR, 3-year OS and major complications rate. Regarding 1-year OS, a higher rate was observed in the MWA group.

Conclusion: MWA and RFA are effective and safe techniques in early stage, BCLC-A, HCCMWA resulted in better 1-year OS, although this benefit was not confirmed in the 3-year analysis.

Keywords: Hepatocellular carcinoma; liver cancer; microwave ablation; radiofrequency ablation.

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Conflict of interest statement

The Authors have stated that they have no conflicts of interest in relation to this study.

Figures

Figure 1
Figure 1. Risk of bias graph: Authors’ judgements on each risk of bias item presented as percentages across all included studies
Figure 2
Figure 2. Study flow diagram
Figure 3
Figure 3. Forest plot of comparison between MWA and RFA; the outcome was Odds Ratio of Complete Ablation (CA) rate. CI: Confidence interval
Figure 4
Figure 4. Forest plot of comparison between MWA and RFA; the outcome was Odds Ratio of Local Recurrence (LR) rate. CI: Confidence intervaI
Figure 5
Figure 5. Forest plot of comparison between MWA and RFA; the outcome was Odds Ratio of 1-year Overall Survival (OS) rate. CI: Confidence intervaI
Figure 6
Figure 6. Forest plot of comparison between MWA and RFA; the outcome was Odds Ratio of 3-year Overall Survival (OS). CI: Confidence intervaI
Figure 7
Figure 7. Forest plot of comparison between MWA and RFA; the outcome was Odds Ratio of major complications rate. CI: Confidence intervaI
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