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. 2025 May 22:12:1587435.
doi: 10.3389/fsurg.2025.1587435. eCollection 2025.

Efficacy and safety of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma at specific anatomic sites of the liver: a systematic review and meta-analysis

Jiandong Zha  1 , Fang Zhang  1 , Tuoyu Cao  1 , Shasha Li  1 , Xuelian Shen  2 , Liangliang Xu  1   3 , Wenqi Chen  1
Affiliations

Efficacy and safety of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma at specific anatomic sites of the liver: a systematic review and meta-analysis

Jiandong Zha et al. Front Surg. .

Abstract

Objective: This meta-analysis aims to assess the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) located at specific anatomic sites of the liver with those of non-specific sites.

Methods: A systematic search was conducted across five databases, covering the period from the establishment of each database to September 30, 2024. Prospective and retrospective studies involving ultrasound-guided percutaneous MWA for the treatment of HCC were included. Data extraction and statistical analysis were performed using Stata 15.1 software. The main outcomes were 1-year, 3-year, and 5-year overall survival rates, complete ablation rates, and major complication rates. The results were presented as odds ratios (OR) with 95% confidence intervals (CI).

Results: A total of 9 studies were included, involving 2,381 patients, of which 1,047 had HCC at specific anatomic sites, and 1,334 had HCC at non-specific sites. The OR values (95% CI) for overall survival at 1 year, 3 years, and 5 years for patients with HCC at specific anatomic sites compared to non-specific sites were 0.89 (0.59, 1.35), 0.83 (0.66, 1.05), and 1.12 (0.91, 1.38), respectively. The OR for complete ablation rate was 0.97 (0.61, 1.53), and the OR for major complications was 1.44 (0.59, 3.51).

Conclusion: Ultrasound-guided percutaneous MWA for HCC at specific anatomic sites shows similar efficacy and safety to that at non-specific sites, with no significant differences in survival rates, complete ablation rates, or complication rates.

Keywords: liver cancer; meta-analysis; microwave ablation; specific anatomical sites; ultrasound guidance.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram illustrating the literature screening process for identifying eligible studies for inclusion in the meta-analysis.
Figure 2
Figure 2
Forest plots of overall survival rates between HCC in special and non-special liver locations. (A) 1-year overall survival rate; (B) 3-year overall survival rate; (C) 5-year overall survival rate; (D) Complete ablation rate.
Figure 3
Figure 3
Forest plot comparing the incidence of major complications between HCC patients treated with MWA in special and non-special liver locations.
See this image and copyright information in PMC

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