Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma: A PRISMA-compliant systematic review and meta-analysis.
Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma: A PRISMA-compliant systematic review and meta-analysis.
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射频消融与微波消融治疗早期肝细胞癌：一项符合prisma标准的系统评价和荟萃分析
DOI：
10.1097/md.0000000000022703
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发表时间：
2020-10-23
期刊：
影响因子：
1.6
通讯作者：
Wang K
中科院分区：
文献类型：
--
作者：
Han J;Fan YC;Wang K
多年来，多项随机对照试验(RCT)比较了微波消融术(MWA)和射频消融术(RFA)治疗肝细胞癌的疗效。本研究的目的是比较RFA和MWA治疗早期肝癌的疗效。系统地在Emabse、Ovid Medline、PubMed和Cochrane图书馆上搜索了这些研究，直到2020年3月20日。连续变量和二分变量分别用加权平均差(WMD)和优势比(OR)进行比较。为了比较总生存期(OS)和无病生存期(DFS)，从单因素分析或生存图中提取风险比(HR)和95%可信区间(CI)。我们的研究共纳入26项研究(5项随机对照试验和21个队列)，4396名患者(RFA组2393名患者，MWA组2003名患者)。在这些患者中，47%的患者在全身麻醉下接受治疗，而射频消融组则有84%(OR = 0.529，P <； .001)。微波消融组平均消融时间(12 分钟)明显短于射频消融组(29 分钟)( = -15.674，P <； .001)。总体而言，在随访期间，微波消融组有17.6%的患者进展，而射频消融组只有19.5%(OR = 0.877，P = .225)。两组患者的OS和DFS差异无统计学意义(HR = 分别为0.891和1.014，P = 分别为.222和.852)。在早期肝癌的治疗中，MWA的疗效与RFA相似。在消融时间较短的情况下，可在局麻下进行MWA。
Several randomized control trials (RCTs) were conducted to compare microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) over the years. The purpose of this study was to compare the efficacy of RFA and MWA for early stage HCC. Studies were systematically searched on Emabse, Ovid Medline, PubMed, and Cochrane Library until March 20, 2020. Continuous variables and dichotomous variables were compared using weighted mean difference (WMD) and odds ratio (OR), respectively. For the comparison of overall survival (OS) and disease-free survival (DFS), the hazard ratio (HR) and 95% confidence interval (CI) were extracted from univariate analysis or survival plots. A total of 26 studies (5 RCTs and 21 cohorts) with 4396 patients (2393 patients in RFA and 2003 patients in MWA) were included in our study. Of these patients, 47% received treatment under general anesthesia in the MWA group and 84% in the RFA group (OR = 0.529, P < .001). The median ablation time was reduced in the MWA group (12 minutes) compared with RFA group (29 minutes) (WMD = –15.674, P < .001). In total, 17.6% patients exhibited progression during follow-up in the MWA group compared with 19.5% in the RFA group (OR = 0.877, P = .225). No statistically significant differences were observed between MWA and RFA groups in terms of OS and DFS (HR = 0.891 and 1.014, P = .222 and .852, respectively). MWA exhibited similar therapeutic effects as RFA in the treatment of early stage HCC. Given the shorter ablation time, MWA can be performed under local anesthesia.