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Volume 40 Issue 9
Sep.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(9): 1807-1815

Efficacy and safety of microwave ablation versus hepatic resection in treatment of hepatocellular carcinoma with liver cirrhosis： A Meta-analysis

DOI: 10.12449/JCH240915
  • 1.

    Department of Infectious Diseases，The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China

  • 2.

    School of Clinical Medicine，Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China

  • 3.

    Department of Traditional Chinese Medicine，Caojiaxiang Community Health Service Center，Chengdu 610081，China

Research funding:

Science and Technology Foundation Project of Hospital of Chengdu University of Traditional Chinese Medicine (21YY03)

More Information
  • Corresponding author: HU Xiaoyu， xiaoyuhu@aliyun.com （ORCID： 0000-0003-0187-4386）
  • Received Date: 2024-02-18
  • Accepted Date: 2024-04-01
  • Published Date: 2024-09-25
    Abstract
  •   Objective  To investigate the efficacy and safety of microwave ablation （MWA） versus hepatic resection （HR） in the treatment of hepatocellular carcinoma （HCC） with liver cirrhosis using a meta-analysis.  Methods  This study was conducted according to the PRISMA guideline， with a PROSPERO registration number of CRD42024509185. PubMed， the Cochrane Library， EMBASE， Web of Science， CNKI， VIP， and Wanfang Data were searched for randomized controlled trials （RCTs） and cohort studies on MWA versus HR in the treatment of HCC with liver cirrhosis published up to November 2023， and Stata 12.0 was used to perform the meta-analysis.  Results  A total of 3 RCTs and 5 retrospective cohort studies were included， with 953 patients in total. The meta-analysis showed that there were no differences between MWA and HR in 1-， 2-， 3-， and 5-year overall survival （OS） rates （all P>0.05） and 1-， 2-， and 5-year recurrence rates （all P>0.05）. Compared with HR， MWA had a significantly higher 3-year recurrence rate （risk ratio ［RR］=1.59， 95% confidence interval ［CI］： 1.08‍ ‍—‍ ‍2.33， P=0.017） and significantly lower 1-， 3-， and 5-year disease-free survival （DFS） rates （1-year DFS rate： RR=0.94， 95%CI： 0.89‍ ‍—‍ ‍0.99， P=0.018， I2=0.0%； 3-year DFS rate： RR=0.84， 95%CI： 0.72‍ ‍—‍ ‍0.98， P=0.023， I2=25.4%； 5-year DFS rate： RR=0.75， 95%CI： 0.58‍ ‍—‍ ‍0.98， P=0.032， I2=34.6%）. However， subgroup analysis showed that there were no significant differences between MWA and HR in 1-， 2-， and 3-year OS rates and 1- and 3-year DFS rates in the RCT subgroup （all P>0.05）. Compared with HR， MWA had significantly better intraoperative blood loss （standardized mean difference ［SMD］=-2.31， 95%CI： -2.64 to -1.97， P<0.001， I2=3.1%）， time of operation （SMD=-3.38， 95%CI： -4.05 to -2.71， P<0.001， I2=73.8%）， length of hospital stay （SMD=-2.54， 95%CI： -3.27 to -1.80， P<0.001， I2=92.8%）， adverse reactions （RR=0.42， 95%CI： 0.30‍ ‍—‍ ‍0.59， P<0.001， I2=0.0%）， and liver function （SMD=-1.43， 95%CI： -1.89‍ ‍—‍ ‍-0.97， P<0.001）.  Conclusion  There are no significant differences between MWA and HR in local recurrence， DFS， and OS， but MWA tends to have a less intraoperative blood loss， a shorter time of operation， fewer adverse reactions， a less impact on liver function， and a shorter length of hospital stay.

     

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