Comparison of microwave ablation and hepatic resection for hepatocellular carcinoma: a meta-analysis
Received 17 May 2017
Accepted for publication 27 August 2017
Published 3 October 2017 Volume 2017:10 Pages 4829—4839
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Jianmin Xu
Manka Zhang,1 Huimin Ma,2 Jian Zhang,1 Lingling He,3 Xiaohui Ye,4 Xin Li1,2
1Department of Center of Integrated Traditional Chinese and Western Medicine, Peking University Ditan Teaching Hospital, 2Department of Center of Integrated Traditional Chinese and Western Medicine, Beijing Ditan Hospital, Capital Medical University, 3Department of Institute of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, 4Department of Institute of Infectious Disease, Peking University Ditan Teaching Hospital, Beijing, People’s Republic of China
Background and aims: Hepatic 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.
Methods: Six 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.
Results: Nine 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.
Conclusion: In 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.
Keywords: primary hepatic carcinoma, hepatic resection, microwave ablation, survival analysis
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