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

Background: 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.

Methods: 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.

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

Conclusions: 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.

Keywords: carcinoma hepatocellular; liver; liver neoplasms; microwaves; radiofrequency ablation.

PICO
Population: liver cancer
Intervention: 1. microwave ablation; 2. radiofrequency ablation
Outcomes: 1. complete ablation (CA); 2. local tumor prgression (LTP); 3. intrahepatic distant (IDR); 4. complications

Included studies:
title: Percutaneous cooled-probe microwave versus radiofrequency ablation in early-stage hepatocellular carcinoma: a phase III randomised controlled trial
title: Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial
title: Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial
title: Efficacy and survival analysis of percutaneous radiofrequency versus microwave ablation for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience
title: Coagulation areas produced by cool-tip radiofrequency ablation and microwave ablation using a device to decrease back-heating effects: a prospective pilot study
title: Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies
title: Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases. A monocentric initial experience
title: A comparison of microwave thermosphere versus radiofrequency thermal ablation in the treatment of colorectal liver metastases
title: Percutaneous Microwave versus Radiofrequency Ablation of Colorectal Liver Metastases: Ablation with Clear Margins (A0) Provides the Best Local Tumor Control
title: MWA Versus RFA for Perivascular and Peribiliary CRLM: A Retrospective Patient- and Lesion-Based Analysis of Two Historical Cohorts
title: Microwave versus Radiofrequency Ablation Treatment for Hepatocellular Carcinoma: A Comparison of Efficacy at a Single Center
title: Ultrasound-guided ablative therapy for hepatic malignancies : a comparison of the therapeutic effects of microwave and radiofrequency ablation
title: Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma
title: Efficacy and safety of thermal ablation in patients with liver metastases
title: Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation