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

Abstract

Background and aimsHepatic resection (HRN) and microwave ablation (MWA) have significant advantages in treating hepatocellular carcinoma; however, it remains unclear which way produces better outcomes. This meta-analysis of cohort studies compared the treatments in terms of effectiveness and safety.MethodsSix electronic databases (PubMed, Medline, EMBASE, Web of Science, EBSCO, and The Cochrane Library) were retrieved for studies comparing MWA and HRN. The meta-analysis was conducted based on statement of preferred reporting items for systematic reviews and meta-analyses.ResultsNine studies met the inclusion criteria, with a total of 1,480 patients. The overall meta-analysis demonstrated no significant difference in overall survival between the MWA group and the HRN group (HR =0.98, 95% CI =0.76–1.26, P=0.878). There was no difference in disease-free survival between the MWA group and the HRN group (HR =1.16, 95% CI =0.79–1.71, P=0.442). Meanwhile, the meta-analysis demonstrated that MWA was associated with shorter operation time (standardized mean difference [SMD] =−1.37, 95% CI =−1.92 to −0.81, P=0.000), less amount of blood loss in operation (SWD =−1.19, 95% CI =−1.76 to −0.61, P=0.000), and less complications (OR =0.22, 95% CI =0.12–0.40, P=0.000) than HRN.ConclusionIn conclusion, our meta-analysis suggests that MWA may be superior to HRN as it is as effective as HRN in terms of overall survival, disease-free survival, tumor recurrence, and is associated with shorter operation time, less amount of blood loss, and fewer complications.