Microwave ablation determines similar survival outcomes as compared to radiofrequency ablation for the treatment of hepatocellular carcinoma
Amer Khan , Marcin Mostowy , Michael Owusu , Mercy Mutambanengwe , Sam Habimana , Somoskoi Bence & show all
Received 19 Nov 2020, Accepted 24 Dec 2020, Accepted author version posted online: 25 Dec 2020, Published online: 30 Dec 2020
It is still unclear whether microwave ablation (MWA) outperforms radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC). Aim of this manuscript is to compare the two treatments through a meta-analysis of randomized-controlled trials (rcts).
Methods
Computerized bibliographic search was performed on main databases through August 2020. The primary outcome was the complete response rate, with survival rate, disease-free survival rate, and adverse event rate as secondary outcomes. Results were expressed in terms of risk ratio (RR) and 95% confidence interval (CI)
Results
Seven rcts enrolling 1143 patients were included. Rates of complete response were similar (RR 1.01, 95% CI 0.99–1.02); likewise, survival rates were constantly similar, with rrs ranging from 1.05 (0.96–1.15) at 1-year to 0.91 (0.81–1.03) at 5-year. Disease-free survival at 1-, 2-, and 3-year was similar between the two groups with RR 1.00 (0.96–1.04), 0.94 (0.84–1.06), and 1.06 (0.93–1.21), respectively. On the other hand, RR for disease-free survival at 5-year was significantly in favor of MWA (3.66, 1.32–42.27). Adverse event rate was similar between the two treatments (RR 1.06, 0.48–2.34), with bleeding and hematoma as most frequent complications.
Conclusions
MWA seems to determine similar outcomes as compared to RFA.