中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 5
May  2018
Turn off MathJax
Article Contents
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.

     

    • FullText(HTML)
  • loading
    • References(37)
  • [1]BRUIX J, SHERMAN M.Management of hepatocellular carcinoma:an update[J].Hepatology, 2011, 53 (3) :1020-1022.
    [2]NISHIKAWA H, KIMURA T, KITA R, et al.Radiofrequency ablation for heatocellular carcinoma[J].Int J Hyerthermia, 2013, 29 (6) :558-568.
    [3]SIMON CJ, DUPUY DE, MAYO-SMITH WW.Microwave ablation:principles and applications[J].Radiographics, 2005, 25 (Suppl 1) :s69-s83.
    [4]LENCIONI R, CROCETTI L.Local-regional treatment of hepatocellular carcinoma[J].Radiology, 2012, 262 (1) :43-58.
    [5]THORLUND K, ENGSTRM J, WETTERSLEV J, et al.User manual for trial sequential analysis (TSA) :Copenhagen Trial Unit.Copenhagen, Denmark:Centre for Clinical Intervention Research[EB/OL].[2017-11-02]http://www.ctu.dk/tsa.
    [6]HIGGINS JPT, GREEN S.Cochrane Handbook for Systematic Reviews of Interventions Version5.1.0[EB/OL].[2017-11-02]http://training.cochrane.org/handbook
    [7]WELLS GA, SHEA B, O’CONNELL D, et al.The NewcastleOttawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses[EB/OL].[2017-11-02]http://www.ohri.ca/programs/clinical epidemiology/oxford.htm.
    [8]SHIBATA T, IIMURO Y, YAMAMOTO Y, et al.Small hepatocellular carcinoma:Comparison of radiofrequency ablation and percutaneous microwave coagulation therapy[J].Radiology, 2002, 223 (2) :331-337.
    [9]GU QF, ZHOU DJ, LI YH, et al.Comparison of ultrasoundguided microwave ablation and radiofrequency ablation in the treatment of small hepatocellular carcinoma[J].J Med Theor&Pract, 2010, 23 (6) :683-684. (in Chinese) 古琼芳, 周懂晶, 李益红, 等.超声引导下微波与射频消融治疗小肝癌的临床疗效比较[J].医学理论与实践, 2010, 23 (6) :683-684.
    [10]TIAN WS, KUANG M, LYU M, et al.Ultrasound guided percutaneous radiofrequency ablation and microwave ablation for liver tumors:a randomized controlled trial[J].Chin J Hepatobiliary Surg, 2014, 20 (2) :119-122. (in Chinese) 田文硕, 匡铭, 吕明, 等.超声引导经皮射频消融与微波消融治疗肝脏肿瘤的随机对照研究[J].中华肝胆外科杂志, 2014, 20 (2) :119-122.
    [11]WANG XG, PAN JR, ZHANG F.Percutaneous radiofrequency ablation and microwave ablation in the treatment of primary hepatocellular carcinoma[J].Chin J Med Imaging, 2015, 23 (8) :606-609. (in Chinese) 王喜功, 潘吉荣, 张峰.超声引导下经皮射频消融与微波消融治疗原发性肝细胞癌的比较[J].中国医学影像学杂志, 2015, 23 (8) :606-609.
    [12]XU J, ZHAO Y, FU XD, et al.Comparative analysis of microwave ablation and percutaneous radiofrequency ablation in the treatment of primary hepatocellular carcinoma[J].China Med Equip, 2016, 13 (12) :55-58. (in Chinese) 徐娟, 赵晔, 付晓丹, 等.超声引导下经皮微波消融与射频消融治疗原发性肝癌的临床疗效对比分析[J].中国医学装备, 2016, 13 (12) :55-58.
    [13]SHEN Z, YAN H.Comparative analysis of microwave ablation and percutaneous radiofrequency ablation in the treatment of primary hepatocellular carcinoma[J].Mod J Integr Tradit Chin West Med, 2016, 25 (33) :3659-3662. (in Chinese) 沈桢, 阎皓.射频消融与微波消融治疗原发性小肝癌安全性、有效性及免疫功能影响的对比研究[J].现代中西医结合杂志, 2016, 25 (33) :3659-3662.
    [14]OHMOTO K, YOSHIOKA N, TOMIYAMA Y, et al.Comparison of therapeutic effects between radiofrequency ablation and percutaneous microwave coagulation therapy for small hepatocellular carcinomas[J].J Gastroenterol Hepatol, 2009, 24 (2) :223-227.
    [15]LU MD, XU HX, XIE XY, et al.Percutaneous microwave and radiofrequency ablation for hepatocellular carcinoma:a retrospective comparative study[J].J Gastroenterol, 2005, 40 (11) :1054-1060.
    [16]DING J, JING X, LIU J, et al.Comparison of two different thermal techniques for the treatment of hepatocellular carcinoma[J].Eur J Radiol, 2013, 82 (9) :1379-1384.
    [17]ZHANG L, WANG N, SHEN Q, et al.Therapeutic efficacy of percutaneous radiofrequency ablation versus microwave ablation for hepatocellular carcinoma[J].PLo S One, 2013, 8 (10) :e76119.
    [18]ABDELAZIZ AO, NABEEL MM, ELBAZ TM, et al.Microwave ablation versus transarterial chemoembolization in large hepatocellular carcinoma:prospective analysis[J].Scand J Gastroenterol, 2015, 50 (4) :479-484.
    [19]VOGL TJ, FARSHID P, NAGUIB NN, et al.Ablation therapy of hepatocellular carcinoma:A comparative study between radiofrequency and microwave ablation[J].Abdom Imaging, 2015, 40 (6) :1829-1837.
    [20]HU P, QIAN GJ, SUN AX, et al.Comparsion the efficacy and safety of radiofrequency ablation and microwave ablation for elderly hepatocellular carcinoma patients[J].J Hepatobiliary Surg, 2012, 20 (5) :348-352. (in Chinese) 胡鹏, 钱国军, 孙爱学, 等.微波和射频治疗高龄肝癌患者疗效和安全性比较[J].肝胆外科杂志, 2012, 20 (5) :348-352.
    [21]XU HX, XIE XY, LU MD, et al.Ultrasound-guided percutaneous thermal ablation of hepatocellular carcinoma using microwave and radiofrequency ablation[J].Clin Radiol, 2004, 59 (1) :53-61.
    [22]YIN XY, XIE XY, LU MD, et al.Percutaneous thermal ablation of medium and large hepatocellular carcinoma:long-term outcome and prognostic factors[J].Cancer, 2009, 115 (9) :1914-1923.
    [23]GUO ZY, FU LP, FU ZG, et al.Comparison of efficacy of percutaneous radiofrequency ablation and microwave ablation for liver cancer[J].Pract J Cancer, 2015, 30 (9) :1386-1388. (in Chinese) 郭志远, 付吕平, 付志国, 等.经皮射频消融术与微波消融治疗肝癌的治疗效果对比[J].实用癌症杂志, 2015, 30 (9) :1386-1388.
    [24]QIAN GJ, WANG N, SHEN Q, et al.Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma:Experimental and clinical studies[J].Eur Radiol, 2012, 22 (9) :1983-1990.
    [25]XU Q, KOBAYASHI S, YE X, et al.Comparison of hepatic resection and radiofrequency ablation for small hepatocellular carcinoma:a meta-analysis of 16, 103 patients[J].Sci Rep, 2014, 4 (Suppl) :7252.
    [26]QI X, TANG Y, AN D, et al.Radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma:a meta-analysis of randomized controlled trials[J].J Clin Gastroenterol, 2014, 48 (5) :450-457.
    [27]SUN B, ZHENG CS, FENG GS, et al.Radiofrequency ablation versus surgical resection for small hepatocellular carcinoma:a meta-analysis[J].World Chin J Dig, 2011, 19 (31) :3255-3263. (in Chinese) 孙彪, 郑传胜, 冯敢生, 等.射频消融对比手术切除治疗小肝癌的Meta分析[J].世界华人消化杂志, 2011, 19 (31) :3255-3263.
    [28]FENG Q, CHI Y, LIU Y, et al.Efficacy and safety of percutaneous radiofrequency ablation versus surgical resection for small hepatocellular carcinoma:a meta-analysis of 23 studies[J].J Cancer Res Clin Oncol, 2015, 141 (1) :1-9.
    [29]LI L, ZHANG J, LIU X, et al.Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma:a meta-analysis[J].J Gastroenterol Hepatol, 2012, 27 (1) :51-58.
    [30]SEKI T, WAKABAYASHI M, NAKAGAWA T, et al.Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma[J].Cancer, 1994, 74 (3) :817-825.
    [31]LI M, YU X, LIANG P, et al.Ultrasound-guided percutaneous microwave ablation for hepatic malignancy adjacent to the gallbladder[J].Int J Hyperthermia, 2015, 31 (6) :579-587.
    [32]LIVRAGHI T, MELONI F, SOLBIATI L, et al.Collaborative Italian Group using AMICA system.Complications of microwave ablation for liver tumors:Results of a multicenter study[J].Cardiovasc Intervent Radiol, 2012, 35 (4) :868-874.
    [33]CHINNARATHA MA, CHUANG MY, FRASER RJ, et al.Percutaneous thermal ablation for primary hepatocellualr carcinoma:a systematic review and meta-analysis[J].J Gastroenterol Hepatol, 2016, 31 (2) :294-301.
    [34]FACCIORUSSO A, di MASO M, MUSCATIELLO N.Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma:a systematic review and meta-analysis[J].Int J Hyperthermia, 2016, 32 (3) :339-344.
    [35]WANG YB, LIAO JT, LI YY, et al.Comparison of percutaneous microwave ablation and radiofrequency ablation in the treatment of hepatocellular carcinoma:a Meta analysis[J].Chin J Med Imaging Technol, 2014, 30 (12) :1869-1873. (in Chinese) 王译斌, 廖锦堂, 李悦怡, 等.对比经皮微波消融与射频消融治疗肝癌疗效的Meta分析[J].中国医学影像技术, 2014, 30 (12) :1869-1873.
    [36]WRIGHT AS, LEE FT, MAHVI DM.Hepatic microwave ablation with multiple antennae results in synergistically larger zones of coagulation necrosis[J].Ann Surg Oncol, 2003, 10 (3) :275-283.
    [37]LU LG.Advances in early screening and diagnosis of hepatocellular carcinoma[J].J Clin Hepatol, 2017, 33 (7) :1257-1261. (in Chinese) 陆伦根.原发性肝癌的早期筛查及诊断[J].临床肝胆病杂志, 2017, 33 (7) :1257-1261.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (2350) PDF downloads(364) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return