Comparison of microwave ablation and hepatic resection for hepatocellular carcinoma: a meta-analysis

BACKGROUND AND AIMS: Hepatic resection (HRN) and microwave ablation (MWA) have significant advantages in treating hepatocellular carcinoma; however, it remains unclear which way produces better outcomes. This meta-analysis of cohort studies compared the treatments in terms of effectiveness and safety. METHODS: Six electronic databases (PubMed, Medline, EMBASE, Web of Science, EBSCO, and The Cochrane Library) were retrieved for studies comparing MWA and HRN. The meta-analysis was conducted based on statement of preferred reporting items for systematic reviews and meta-analyses. RESULTS: Nine studies met the inclusion criteria, with a total of 1,480 patients. The overall meta-analysis demonstrated no significant difference in overall survival between the MWA group and the HRN group (HR =0.98, 95% CI =0.76–1.26, P=0.878). There was no difference in disease-free survival between the MWA group and the HRN group (HR =1.16, 95% CI =0.79–1.71, P=0.442). Meanwhile, the meta-analysis demonstrated that MWA was associated with shorter operation time (standardized mean difference [SMD] =−1.37, 95% CI =−1.92 to −0.81, P=0.000), less amount of blood loss in operation (SWD =−1.19, 95% CI =−1.76 to −0.61, P=0.000), and less complications (OR =0.22, 95% CI =0.12–0.40, P=0.000) than HRN. CONCLUSION: In conclusion, our meta-analysis suggests that MWA may be superior to HRN as it is as effective as HRN in terms of overall survival, disease-free survival, tumor recurrence, and is associated with shorter operation time, less amount of blood loss, and fewer complications.