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Meta-Analysis
. 2021 Jun 25;55(3):247-258.
doi: 10.2478/raon-2021-0030.

Microwave ablation compared with radiofrequency ablation for the treatment of liver cancer: a systematic review and meta-analysis

Antonios E Spiliotis  1 , Gereon Gäbelein  1 , Sebastian Holländer  1 , Philipp-Robert Scherber  1 , Matthias Glanemann  1 , Bijendra Patel  2
Affiliations
Meta-Analysis

Microwave ablation compared with radiofrequency ablation for the treatment of liver cancer: a systematic review and meta-analysis

Antonios E Spiliotis et al. Radiol Oncol. .

Abstract

Background: Guidelines have reported that although microwave ablation (MWA) has potential advantages over radiofrequency ablation (RFA), superiority in efficacy and safety remain unclear. Aim of the study is to compare MWA with RFA in the treatment of liver cancer.

Methods: Meta-analysis was conducted according to the PRISMA guidelines for studies published from 2010 onwards. A random-effects model was used for the meta-analyses. Complete ablation (CA), local tumor progression (LTP), intrahepatic distant recurrence (IDR), and complications were analyzed.

Results: Four randomized trials and 11 observational studies with a total of 2,169 patients met the inclusion criteria. Although overall analysis showed no significant difference in LTP between MWA and RFA, subgroup analysis including randomized trials for patients with hepatocellular cancer (HCC) demonstrated statistically decreased rates of LTP in favor of MWA (OR, 0.40; 95% CI, 0.18-0.92; p = 0.03). No significant differences were found between the two procedures in CA, IDR, complications, and tumor diameter less or larger than 3 cm.

Conclusions: MWA showed promising results and demonstrated better oncological outcomes in terms of LTP compared to RFA in patients with HCC. MWA can be utilized as the ablation method of choice in patients with HCC.

Keywords: carcinoma hepatocellular; liver; liver neoplasms; microwaves; radiofrequency ablation.

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Figures

Figure 1
Figure 1
Prisma flow diagram. MWA = microwave ablation, RFA = radiofrequency ablation, TACE = transarterial chemoembolization
Figure 2
Figure 2
Forest plot of random-effects meta-analysis results for complete ablation rates in the MWA and RFA group. CI = confidence interval, MWA = microwave ablation, OR = odds ratio, RFA = radiofrequency ablation
Figure 3
Figure 3
Forest plot of random-effects meta-analysis results for local tumor progression in the RFA and MWA group. CI = confidence interval, MWA = microwave ablation, OR = odds ratio, RFA = radiofrequency ablation
Figure 4
Figure 4
Forest plot of random-effects meta-analysis results for local tumor progression in the RFA and MWA group based on the study type. CI = confidence interval, MWA = microwave ablation, OR = odds ratio, RFA = radiofrequency ablation
Figure 5
Figure 5
Forest plot of random-effects meta-analysis results for intrahepatic distant recurrence rates in the RFA and MWA group. CI = confidence interval, MWA = microwave ablation, OR = odds ratio, RFA = radiofrequency ablation
Figure 6
Figure 6
Forest plot of random-effects meta-analysis results for complication rates following RFA and MWA. CI = confidence interval, MWA = microwave ablation, OR = odds ratio, RFA = radiofrequency ablation
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