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Review
. 2024 Aug 27;16(8):e67938.
doi: 10.7759/cureus.67938. eCollection 2024 Aug.

Comparison of Radiofrequency Ablation and Microwave Ablation for the Management of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Tariq M Shaqran  1 , Jaber Alharbi  2 , Shahad K Al-Hunbusi  3 , Rayan A Alharbi  4 , Mayadah Alawaji  5 , Aman M Diqarshawi  6 , Rakan J Almokhlef  7 , Alanoud A Alfaqih  8 , Ruyuf A Alhumaidi  3 , Hussam A Alzahrani  3 , Ibtesam M Alzyad  9 , Zainab S Alwusaybie  10 , Nashmi M Alotaibi  2 , Nawaf Jamaan Alzahrani  11
Affiliations
Review

Comparison of Radiofrequency Ablation and Microwave Ablation for the Management of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Tariq M Shaqran et al. Cureus. .

Abstract

Hepatocellular carcinoma (HCC) is a common critical type of hepatic cancer worldwide. Recent guidelines have considered ablative therapeutic approaches as the primary option for managing early-stage surgically untreatable HCC. Among these therapies, radiofrequency ablation (RFA) and microwave ablation (MWA) have attained a significant role due to their efficacy and theoretical advantages. This review aims to compare and analyze the efficacy and safety of two common modalities, i.e., MWA and RFA, in the management of HCC. The literature search included PubMed, Cochrane Central Register of Controlled Trials, Medline, and Ovid for articles published until 2024. The outcomes included the local tumor progression (LTP), complete ablation (CA), the overall survival (OS) rate, or major complications. A meta-analysis was performed using Review Manager 5.3. The systematic review included six randomized controlled trials, including 826 patients. The findings revealed that MWA resulted in lower LTP and higher CA rates compared to RFA. However, the effect of complications was higher in the MWA therapy group. Despite that, the differences between all parameters were not significant. Statistical significance was not evident in the OS rates between the two modalities. Three studies found comparable survival rates between the two modalities, while one study reported similar local tumor recurrence-free survival rates between the two approaches. Both techniques appear to be effective and safe for the management of liver tumors, providing clinicians with valuable options for personalized patient care. Further high-quality research is needed to confirm these findings and guide clinical decision-making.

Keywords: ablative therapies; carcinoma; hepatocellular carcinoma; microwave ablation; radiofrequency ablation.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of the included studies.
Figure 2
Figure 2. Risk of bias forest plots.
Figure 3
Figure 3. Risk of bias summary.
Figure 4
Figure 4. Forest plot comparing LTP between MWA and RFA.
LTP: local tumor progression; RFA: radiofrequency ablation; MWA: microwave ablation; M-H: Mantel-Haenszel method
Figure 5
Figure 5. Forest plot comparing the CA rate between MWA and RFA.
CA: complete ablation; RFA: radiofrequency ablation; MWA: microwave ablation; M-H: Mantel-Haenszel method
Figure 6
Figure 6. Forest plot comparing major complications.
RFA: radiofrequency ablation; MWA: microwave ablation; M-H: Mantel-Haenszel method
See this image and copyright information in PMC

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