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超声引导下经皮微波消融治疗肝脏特定解剖部位肝细胞癌的疗效与安全性:一项系统评价和荟萃分析

Efficacy and safety of ultrasound-guided percutaneous microwave ablation for hepatocellular carcinoma at specific anatomic sites of the liver: a systematic review and meta-analysis.

作者信息

Zha Jiandong, Zhang Fang, Cao Tuoyu, Li Shasha, Shen Xuelian, Xu Liangliang, Chen Wenqi

机构信息

Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China.

Department of Ultrasound Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China.

出版信息

Front Surg. 2025 May 22;12:1587435. doi: 10.3389/fsurg.2025.1587435. eCollection 2025.

Abstract

OBJECTIVE

This meta-analysis aims to assess the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) located at specific anatomic sites of the liver with those of non-specific sites.

METHODS

A systematic search was conducted across five databases, covering the period from the establishment of each database to September 30, 2024. Prospective and retrospective studies involving ultrasound-guided percutaneous MWA for the treatment of HCC were included. Data extraction and statistical analysis were performed using Stata 15.1 software. The main outcomes were 1-year, 3-year, and 5-year overall survival rates, complete ablation rates, and major complication rates. The results were presented as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS

A total of 9 studies were included, involving 2,381 patients, of which 1,047 had HCC at specific anatomic sites, and 1,334 had HCC at non-specific sites. The OR values (95% CI) for overall survival at 1 year, 3 years, and 5 years for patients with HCC at specific anatomic sites compared to non-specific sites were 0.89 (0.59, 1.35), 0.83 (0.66, 1.05), and 1.12 (0.91, 1.38), respectively. The OR for complete ablation rate was 0.97 (0.61, 1.53), and the OR for major complications was 1.44 (0.59, 3.51).

CONCLUSION

Ultrasound-guided percutaneous MWA for HCC at specific anatomic sites shows similar efficacy and safety to that at non-specific sites, with no significant differences in survival rates, complete ablation rates, or complication rates.

摘要

目的

本荟萃分析旨在评估超声引导下经皮微波消融(MWA)治疗位于肝脏特定解剖部位的肝细胞癌(HCC)与非特定部位的疗效和安全性。

方法

对五个数据库进行系统检索,涵盖各数据库建立至2024年9月30日的时间段。纳入涉及超声引导下经皮MWA治疗HCC的前瞻性和回顾性研究。使用Stata 15.1软件进行数据提取和统计分析。主要结局指标为1年、3年和5年总生存率、完全消融率和主要并发症发生率。结果以比值比(OR)及95%置信区间(CI)表示。

结果

共纳入9项研究,涉及2381例患者,其中1047例HCC位于特定解剖部位,1334例HCC位于非特定部位。与非特定部位相比,特定解剖部位HCC患者1年、3年和5年总生存的OR值(95%CI)分别为0.89(0.59,1.35)、0.83(0.66,1.05)和1.12(0.91,1.38)。完全消融率的OR为0.97(0.61,1.53),主要并发症的OR为1.44(0.59,3.51)。

结论

超声引导下经皮MWA治疗特定解剖部位的HCC与非特定部位显示出相似的疗效和安全性,在生存率、完全消融率或并发症发生率方面无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7cf/12137246/04b6045989ab/fsurg-12-1587435-g001.jpg

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