Microwave ablation determines similar survival outcomes as compared to radiofrequency ablation for the treatment of hepatocellular carcinoma

ABSTRACT

Objectives

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.

KEYWORDS:

• HCC
• rfa
• mwa
• survival
• recurrence
• liver Cancer

Author contributions

A Khan, M Mostowy, M Owusu, M Mutambanengwe, S Habimana, S Bence, A Facciorusso were involved in the conception and design. A Facciorusso and A Khan were involved in the analysis and interpretation of the data. A Facciorusso and M wusu were involved in the drafting of the paper. A Khan, M Mostowy, M Owusu, M Mutambanengwe, S Habimana, S Bence, and A Facciorusso revised the manuscript critically for intellectual content. All of the authors approved the final version to be published and agree to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.