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Issue 5
May  2018
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Article Navigation >  Journal of Clinical Hepatology  > 2018  >  34(5): 1025-1032

Clinical effect and safety of percutaneous radiofrequency ablation versus microwave ablation in treatment of hepatocellular carcinoma:a Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2018.05.020

  • Shihezi University School of Medicine

  • Received Date: 2017-11-02
  • Published Date: 2018-05-20
    Abstract
  • Objective To investigate the clinical effect and safety of percutaneous radiofrequency ablation ( RFA) versus microwave ablation ( MWA) in the treatment of hepatocellular carcinoma ( HCC) using the meta-analysis and trial sequential analysis ( TSA) . Methods Pub Med, The Cochrane Library ( Issue 6, 2017) , EMbase, CNKI, VIP, CBM, and Wanfang Data were searched for randomized controlled trials ( RCTs) and cohort studies about RFA versus MWA in the treatment HCC published up to June 2017. Two reviewers independently screened the articles, extracted data, and evaluated their quality. Rev Man 5. 3 was used for the meta-analysis, and TSA v0. 9 Beta was used for TSA. Results A total of 6 RCTs and 11 cohort studies were included, with 1782 patients in total. The meta-analysis showed that there were no significant differences between RFA and MWA in complete ablation rate ( odds ratio [OR]= 0. 88, 95% confidence interval [CI]: 0. 63-1. 22, P = 0. 44) , overall local recurrence rate ( OR = 1. 2, 95% CI: 0. 90-1. 59, P = 0. 21) , and 1-and 3-year overall survival rates ( 1-year: OR = 0. 72, 95% CI: 0. 45-1. 14, P = 0. 16; 3-year: OR = 1. 13, 95% CI: 0. 85-1. 50, P = 0. 41) .The subgroup analysis showed that in patients with a tumor diameter of ≤3 cm or 3-5 cm, there were no significant differences in complete ablation rate and local recurrence rate between RFA and MWA, while the MWA group had a significantly shorter ablation time than the RFA group ( MD = 8. 08, 95% CI: 4. 79-11. 37, P < 0. 001) . As for the incidence rate of adverse events, the MWA group had significantly higher incidence rates of liver pain and postoperative pyrexia than the RFA group ( P = 0. 02 and P < 0. 01) . TSA was performed for complete ablation rate, local recurrence rate, and 3-year survival rate, and the results showed that more studies were needed to support this evidence. Conclusion RFA and MWA have a similar clinical effect in the treatment of HCC, and compared with RFA, MWA has a shorter time of operation and a higher incidence rate of complications.

     

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