Comparison of microwave ablation and hepatic resection for hepatocellular carcinoma: a meta-analysis

Figures & data

Figure 1 Flow chart showing selection of studies for meta-analysis.

Abbreviations: MWA, microwave ablation; HRN, hepatic resection; HCC, hepatocellular carcinoma.

Table 1 Characteristics of studies included in the meta-analysis

Authors	Journal name	Study design	Region	Number of patients	Age	Sex	Follow-up	Number of tumors	Tumor size (cm)	Associated with cirrhosis	Tumor stage (BCLC)	Newcastle–Ottawa scale
				(MWA/HRN)	Mean ± SD (years)	(m/f)	Duration (months)	(MWA/HRN)	(MWA/HRN)	(MWA/HRN)
					(MWA/HRN)							Total	Selection	Comparability	Outcome
Li et al^Citation24	Hepatol Res	Retrospective cohort study	People’s Republic of China	60/87	65 (45–71)/63 (40–77)	117/30	1–60	1.017±0.02/1.126±0.05	2.0±0.5/2.3±0.5	–	0/A	7	^****	^*	^**
Zhang et al^Citation20	Eur J Surg Oncol	Retrospective cohort study	People’s Republic of China	68/122	55.4±9.9/49.5±8.6	168/22	9–104	–	2.7±0.3/2.7±0.4	–	0/A	6	^****	–	^**
Xu and Zhao^Citation23	Int J Clin Exp Pathol	Prospective cohort study	People’s Republic of China	45/45	57.9±3.4/58.3±3.1	66/24	1–36	–	3.8±0.9/3.6±0.7		–	6	^**	^**	^**
Shi et al^Citation22	J Gastroenterol Hepatol	Retrospective cohort study	People’s Republic of China	117/107	56.6±9.2/54.5±9.9	180/44	1–101	1.191±0.04/1.178±0.04	–	111/101	–	8	^***	^**	^***
Takami et al^Citation26	J Hepatobiliary Pancreat Sci	Retrospective cohort study	Japan	390/34	67.6±9.1/66.1±7.5	262/162	1–184	1.55±0.75/1.11±0.47	2.08±0.5/2.23±0.7	–	0/A	8	^****	^**	^**
Wang et al^Citation19	J Gastrointest Surg	Retrospective cohort study	People’s Republic of China	114/80	54.82±11.44/57.66±14.31	171/23	1–96	–	–	96/71	–	8	^****	^**	^**
Horigome et al^Citation21	Hepatogastroenterology	Prospective cohort study	Japan	29/43	65±5/63±7	55/17	1–120	–	1.7±0.6/2.3±0.7	–	–	6	^****	–	^**
Midorikawa et al^Citation27	J Hepatobiliary Pancreat Surg	Retrospective cohort study	Japan	38/51	63.8±11.2/61.6±11.2	64/25	2–60	1.9±1.12/1.53±1.05	3.1±1.3/4.5±3.7	31/36	–	8	^****	^**	^**
Yamanaka et al^Citation25	World J Surg	Retrospective cohort study	Japan	27/23	63±7.4/61±7.9	37/13	6–36	1.222±0.1/1.217±0.09	3.3±1.5/3.1±1.8	25/22	–	6	^**	^**	^**

Note: An asterisk indicates one score of each section.

Abbreviations: MWA, microwave ablation; HRN, hepatic resection; BCLC, Barcelona Clinic Liver Cancer.

Figure 2 Forest plot of meta-analysis comparing the OS between MWA and HRN (pooled with HR).

Abbreviations: MWA, microwave ablation; OS, overall survival; HRN, hepatic resection.

Figure 3 Funnel plot for assessing publication bias in OS.

Abbreviations: HR, hazard ratio; OS, overall survival; SE, standard error.

Figure 4 (A) Forest plot of meta-analysis comparing the OS between MWA and HRN (pooled with HR). Comparison of patients with HCC <3 cm. (B) Forest plot of meta-analysis comparing the OS between MWA and HRN (pooled with HR). Comparison of PMCT with HRN.

Abbreviations: HCC, hepatocellular carcinoma; MWA, microwave ablation; OS, overall survival; PMCT, percutaneous microwave coagulation therapy; HRN, hepatic resection.

Figure 5 Forest plot of meta-analysis comparing the OS between MWA and HRN (pooled with OR).

Abbreviations: MWA, microwave ablation; OS, overall survival; HRN, hepatic resection.

Figure 6 Forest plot of meta-analysis comparing the DFS between MWA and HRN (pooled with HR).

Note: Weights are from random effects analysis.
Abbreviations: DFS, disease-free survival; MWA, microwave ablation; HRN, hepatic resection.

Figure 7 Funnel plot for assessing publication bias in DFS.

Abbreviation: DFS, disease-free survival.

Figure 8 (A) Forest plot of meta-analysis comparing the DFS between MWA and HRN (pooled with HR). Comparing the patients with HCC smaller than 3 cm. Weights are from random effects analysis. (B) Forest plot of meta-analysis comparing the DFS between MWA and HRN (pooled with HR). Comparing PMCT with HRN.

Abbreviations: DFS, disease-free survival; HCC, hepatocellular carcinoma; MWA, microwave ablation; PMCT, percutaneous microwave coagulation therapy; HRN, hepatic resection.

Figure 9 Forest plot of meta-analysis comparing the tumor recurrence between MWA and HRN (pooled with OR).

Abbreviations: MWA, microwave ablation; HRN, hepatic resection.

Figure 10 (A) Forest plot of meta-analysis comparing operation time between MWA and HRN. (B) Forest plot of meta-analysis comparing blood loss between MWA and HRN. (C) Forest plot of meta-analysis comparing complication between MWA and HRN. Weights are from random effects analyses.

Abbreviations: MWA, microwave ablation; SMD, standardized mean difference; HRN, hepatic resection.

LiWZhouXHuangZShort- and long-term outcomes of laparoscopic hepatectomy, microwave ablation and open hepatectomy for small hepatocellular carcinoma: a 5-year experience in a single centerHepatol Res201747765065727487979

 PubMed Web of Science ®Google Scholar

ZhangELYangFWuZBTherapeutic efficacy of percutaneous microwave coagulation versus liver resection for single hepatocellular carcinoma ≤3 cm with Child-Pugh A cirrhosisEur J Surg Oncol201642569069726995115

 PubMed Web of Science ®Google Scholar

XuJZhaoYComparison of percutaneous microwave ablation and laparoscopic resection in the prognosis of liver cancerInt J Clin Exp Pathol2015891166526617907

 PubMedGoogle Scholar

ShiJSunQWangYComparison of microwave ablation and surgical resection for treatment of hepatocellular carcinomas conforming to Milan criteriaJ Gastroenterol Hepatol20142971500150724628534

 PubMed Web of Science ®Google Scholar

TakamiYRyuTWadaYEvaluation of intraoperative microwave coagulonecrotic therapy (MCN) for hepatocellular carcinoma: a single center experience of 719 consecutive casesJ Hepatobiliary Pancreat Sci201320333234122710886

 PubMedGoogle Scholar

WangZLLiangPDongBWYuXLYuDJPrognostic factors and recurrence of small hepatocellular carcinoma after hepatic resection or microwave ablation: a retrospective studyJ Gastrointest Surg200812232733717943391

 PubMed Web of Science ®Google Scholar

HorigomeHNomuraTNakaoHTreatment of solitary small hepatocellular carcinoma: consideration of hepatic functional reserve and mode of recurrenceHepatogastroenterology2000473250751110791223

 PubMedGoogle Scholar

MidorikawaTKumadaKKikuchiHMicrowave coagulation therapy for hepatocellular carcinomaJ Hepatobiliary Pancreat Surg20007325225910982623

 PubMedGoogle Scholar

YamanakaNTanakaTOriyamaTMicrowave coagulonecrotic therapy for hepatocellular carcinomaWorld J Surg1996208107610818798367

 PubMedGoogle Scholar