Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis

Abstract

BackgroundPercutaneous ablation has quickly arisen as one of the important alternative treatments for hepatocellular carcinoma (HCC). We aimed to compare the therapeutic effects of radiofrequency ablation (RFA) and other ablative techniques on HCCs.MethodsDatabases were searched to identify literature on complete tumor ablation (CTA), overall survival (OS), local tumor recurrence (LTR), and complications of RFA in the treatment of HCC, compared with those of microwave ablation (MWA), percutaneous ethanol injection (PEI), PEI plus RFA, cryoablation (CRA), laser ablation (LSA), and high-intensity focused ultrasound. Randomized controlled trials and high-quality cohort studies were included in the assessment.ResultsThe effects of MWA and CRA appeared to be similar to those of RFA, but lower rates of LTR and higher rates of CTA in large tumors compared with RFA were reported (P < 0.05). CTA rates were lower in patients treated with PEI (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.06–0.42), and higher in those treated with PEI plus RFA (OR 2.28, 95% CI 1.19–3.60), with an increased incidence of fever (P < 0.05). LSA resulted in lower CTA rates (OR 0.32, 95% CI 0.13–0.81) and OS (hazard ratio 1.47, 95% CI 1.01–2.15), with a lower incidence of complications.ConclusionsCompared with RFA, identical effects were found in MWA and CRA groups. Fewer complications were observed in PEI and LSA group. PEI plus RFA appeared more effective, with a higher rate of complications. Well-designed randomized controlled trials are further needed to confirm above results.

Videolaparoscopic microwave ablation in patients with HCC at a European high‐volume center: Results of 815 procedures

“…The use of MWA has nonetheless been widely questioned because of the potentially higher risk of major biliary damage associated with the greater amount of energy delivered. That said, no differences emerged in the major complication rates between MWA and RFA in a single‐institution study, or a recent systematic literature review . In the present large series, VL MWA was associated with an overall 30.8% morbidity rate.…”

“…That said, no differences emerged in the major complication rates between MWA and RFA in a single-institution study, 32 or a recent systematic literature review. 33 In the present large series, VL MWA was associated with an overall 30.8% morbidity rate. Our results broadly overlap with recent experiences involving RFA, particularly as concerns the reported rate of major complications (2%), 9 which is lower than in earlier reports.…”

Efficacy of radiofrequency ablation and microwave ablation in the treatment of thoracic cancer: A systematic review and meta‐analysis

“…Ablation therapy can also improve the patient's immune ability, and kill small lesions that have not been discovered by medical imaging. Several ablation methods have their own advantages, and the safety of laser and percutaneous ethanol injection is the highest in the treatment of liver cancer . They can be the application in high‐risk areas for protecting the important organs.…”

“…Compared with RFA, identical effects were found in MWA and cryoablation. 19 It showed that RFA appeared more effective, but with a higher rate of complications. This differs from the findings presented here.…”

“…Several ablation methods have their own advantages, and the safety of laser and percutaneous ethanol injection is the highest in the treatment of liver cancer. 19 They can be the application in high-risk areas for protecting the important organs. The effects of microwave ablation and cryoablation are similar.…”