Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis
| Autor: | Mrudula B. Glassberg, Behnam Sadeghirad, George W.J. Wright, Jeffrey W. Clymer, Nicole Ferko, Joseph F. Amaral, Sudip Ghosh, Rana A. Qadeer |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Percutaneous Radiofrequency ablation OncoTargets and Therapy law.invention liver cancer 03 medical and health sciences 0302 clinical medicine law medicine Pharmacology (medical) Original Research business.industry Microwave ablation hepatocellular carcinoma medicine.disease meta-analysis 030104 developmental biology Systematic review Oncology microwave ablation 030220 oncology & carcinogenesis Meta-analysis Hepatocellular carcinoma Observational study radiofrequency ablation Radiology Liver cancer business |
| Zdroj: | OncoTargets and therapy |
| ISSN: | 1178-6930 |
| Popis: | Mrudula B Glassberg,1 Sudip Ghosh,2 Jeffrey W Clymer,3 Rana A Qadeer,4 Nicole C Ferko,4 Behnam Sadeghirad,4 George WJ Wright,4 Joseph F Amaral21Health Economics and Market Access, Ethicon Inc, Somerville, NJ, USA; 2Health Economics and Market Access, Ethicon Inc, Cincinnati, OH, USA; 3Medical Affairs, Ethicon Inc, Cincinnati, OH, USA; 4Cornerstone Research Group, Burlington, ON, CanadaPurpose: Percutaneous ablation techniques, including microwave ablation (MWA) and radiofrequency ablation (RFA), have become important minimally invasive treatment options for liver cancer. This systematic review compared MWA with RFA for treatment of liver cancer.Methods: The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials was conducted for randomized and observational studies published from 2006 onwards. A random-effects model was used for meta-analyses and local tumor progression (LTP), technique efficacy, overall survival (OS), disease-free survival (DFS), intrahepatic de novo lesions (IDL), extrahepatic metastases (EHM), length of stay (LOS), and complications were analyzed. Subgroup and sensitivity analyses were also conducted.Results: Of 1379 studies identified, 28 randomized and observational studies met inclusion criteria. The main analysis demonstrated that LTP was significantly reduced by 30% with MWA versus RFA (RR=0.70; P=0.02) (all studies) and by 45% with MWA versus RFA (RR=0.55; P=0.007) (randomized studies only). There were no significant differences between MWA and RFA for other efficacy and safety outcomes. Higher frequency (2450 MHz) and larger tumor size (≥2.5 cm) are amongst variables that may be associated with improved outcomes for MWA. Sensitivity analyses were generally congruent with the main results.Conclusion: MWA is at least as safe and effective as RFA for treating liver cancer and demonstrated significantly reduced LTP rates. Future studies should assess time and costs associated with these two treatment modalities.Keywords: microwave ablation, radiofrequency ablation, hepatocellular carcinoma, meta-analysis, liver cancer |
| Databáze: | OpenAIRE |
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