微波消融与射频消融治疗巴塞罗那临床肝癌分期 B 期肝癌的争论（永恒的争论）
The (Eternal) Debate on Microwave Ablation Radiofrequency Ablation in BCLC-A Hepatocellular Carcinoma.
机构信息
Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
出版信息
In Vivo. 2020 Nov-Dec;34(6):3421-3429. doi: 10.21873/invivo.12181.
BACKGROUND/AIM: While percutaneous radiofrequency ablation (RFA) is considered the standard ablative modality for the treatment of early-stage hepatocellular carcinoma (HCC), percutaneous microwave ablation (MWA) is being increasingly used in recent years. We performed a systematic review and meta-analysis to compare percutaneous MWA versus percutaneous RFA in BCLC-A HCC across randomized controlled trials (RCTs).
PATIENTS AND METHODS
Eligible studies included RCTs assessing MWA versus RFA in BCLC-A HCC. Outcomes of interest included: complete ablation (CA) rate, local recurrence (LR) rate, 1-year overall survival (OS) rate, 3-year OS rate and major complications rate.
RESULTS
We retrieved all the relevant RCTs through PubMed/Medline, Cochrane library and EMBASE; five eligible studies involving a total of 794 patients (MWA: 409; RFA: 385) and 1008 nodules of HCC (MWA: 519; RFA: 489) were included in our analysis. No significant differences were found between MWA and RFA regarding CA, LR, 3-year OS and major complications rate. Regarding 1-year OS, a higher rate was observed in the MWA group.
CONCLUSION
MWA and RFA are effective and safe techniques in early stage, BCLC-A, HCCMWA resulted in better 1-year OS, although this benefit was not confirmed in the 3-year analysis.
背景/目的：虽然经皮射频消融（RFA）被认为是治疗早期肝细胞癌（HCC）的标准消融方式，但近年来经皮微波消融（MWA）的应用越来越多。我们进行了一项系统评价和荟萃分析，比较了 BCLC-A HCC 中经皮 MWA 与 RFA 的疗效。
患者和方法
纳入的研究包括评估 MWA 与 RFA 在 BCLC-A HCC 中的 RCT。感兴趣的结局包括：完全消融（CA）率、局部复发（LR）率、1 年总生存率（OS）率、3 年 OS 率和主要并发症发生率。
结果
我们通过 PubMed/Medline、Cochrane 图书馆和 EMBASE 检索到所有相关的 RCT；共纳入 5 项符合条件的研究，共纳入 794 例患者（MWA：409 例；RFA：385 例）和 1008 个 HCC 结节（MWA：519 个；RFA：489 个）。MWA 和 RFA 在 CA、LR、3 年 OS 和主要并发症发生率方面无显著差异。在 1 年 OS 方面，MWA 组的生存率更高。
结论
MWA 和 RFA 是早期 BCLC-A HCC 有效的、安全的治疗手段，MWA 可获得更好的 1 年 OS，但在 3 年分析中并未证实这一获益。
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