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微波消融与射频消融治疗转移性肝癌的疗效比较:一项系统评价与荟萃分析

Comparative efficacy of microwave ablation and radiofrequency ablation for treating metastatic liver cancer: a systematic review and meta-analysis.

作者信息

Li Zheng, Yan Tingting, Cai Xiujun

机构信息

Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

National Engineering Research Center of Innovation and Application of Minimally Invasive Instruments, Hangzhou, China.

出版信息

Front Oncol. 2024 Oct 30;14:1473780. doi: 10.3389/fonc.2024.1473780. eCollection 2024.

Abstract

OBJECTIVE

This study aims at evaluating and juxtaposing the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) for hepatic metastases treatment.

METHODS

We undertook an extensive literature search across the Cochrane Library, Web of Science, Embase, PubMed, CNKI, and databases for studies published up to December 2023, assessing the outcomes of RFA versus MWA in hepatic metastases treatment. Studies were included or excluded based on established criteria. Continuous variables were analyzed with the aid of the weighted mean difference (WMD) and its 95% confidence interval (CI), while the odds ratio (OR) with its 95% CI was utilized for dichotomous variables. Data were processed by use of STATA 17.0 software. Key outcomes assessed included ablation time, post-operative local tumor progression (LTP), disease-free survival (DFS), and post-operative complications (POCs).

RESULTS

Seven studies, comprising 357 patients undergoing MWA and 452 patients undergoing RFA, fulfilled the inclusion criteria. As unveiled by the meta-analysis, RFA and MWA did not significantly differ in ablation time, DFS, and POCs. Nonetheless, MWA resulted in a strikingly reduced rate of post-operative LTP versus RFA.

CONCLUSION

MWA offers superior control over post-operative LTP, suggesting better overall efficacy in hepatic metastases treatment compared with RFA.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42023385201.

摘要

目的

本研究旨在评估和比较射频消融(RFA)和微波消融(MWA)治疗肝转移瘤的疗效。

方法

我们在Cochrane图书馆、科学网、Embase、PubMed、中国知网以及截至2023年12月发表研究的数据库中进行了广泛的文献检索,评估RFA与MWA治疗肝转移瘤的疗效。根据既定标准纳入或排除研究。连续变量借助加权平均差(WMD)及其95%置信区间(CI)进行分析,而二分类变量则采用比值比(OR)及其95%CI。数据使用STATA 17.0软件进行处理。评估的关键结局包括消融时间、术后局部肿瘤进展(LTP)、无病生存期(DFS)和术后并发症(POC)。

结果

七项研究符合纳入标准,其中357例患者接受MWA,452例患者接受RFA。荟萃分析显示,RFA和MWA在消融时间、DFS和POC方面无显著差异。然而,与RFA相比,MWA术后LTP发生率显著降低。

结论

MWA对术后LTP的控制效果更佳,表明其在肝转移瘤治疗中的总体疗效优于RFA。

系统评价注册

https://www.crd.york.ac.uk/prospero/,标识符CRD42023385201。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e28/11557459/6274df9620a8/fonc-14-1473780-g001.jpg

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