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

• Published in: Radiology and oncology Vol. 55; no. 3; pp. 247 - 258
• Main Authors: Spiliotis, Antonios E., Gäbelein, Gereon, Holländer, Sebastian, Scherber, Philipp-Robert, Glanemann, Matthias, Patel, Bijendra
• Format: Journal Article
• Language: English
• Published: Poland Sciendo 25.06.2021; De Gruyter Poland
• Subjects: Ablation; Bias; carcinoma hepatocellular; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Clinical trials; Complications; Confidence Intervals; Disease Progression; Guidelines; Humans; Liver; Liver cancer; liver neoplasms; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Long-term potentiation; Meta-analysis; Microwave ablation; microwaves; Microwaves - adverse effects; Microwaves - therapeutic use; Neoplasm Recurrence, Local; Observational Studies as Topic; Odds Ratio; Patients; Radio frequency; Radiofrequency ablation; Radiofrequency Ablation - adverse effects; Radiofrequency Ablation - methods; Randomized Controlled Trials as Topic; Review; Subgroups; Treatment Outcome; Tumor Burden; Tumors; carcinoma hepatocellular; microwaves; liver neoplasms; radiofrequency ablation; liver
• ISSN: 1581-3207; 1318-2099; 1581-3207; 0485-893X
• DOI: 10.2478/raon-2021-0030

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. 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. 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; = 0.03). No significant differences were found between the two procedures in CA, IDR, complications, and tumor diameter less or larger than 3 cm. 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.