Hepatocellular carcinoma abutting large vessels: comparison of four percutaneous ablation systems

Loriaud, Amélie; Denys, Alban; Séror, Olivier; Violi, Naïk Vietti; Digklia, Antonia; Durán, Rafael; Trillaud, Hervé; Hocquelet, Arnaud

doi:10.1080/02656736.2018.1440017

Cited by 28 publications

(23 citation statements)

References 44 publications

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“…After a preliminary review, 418 papers were excluded because they were considered irrelevant studies, case reports, animal studies, comment letters, or reviews. Among 32 potentially relevant papers, we excluded five studies in which patients were treated with embolization combined with MWA or RFA [12][13][14][15][16] and another seven because of insufficient data [17][18][19][20][21][22][23]. Six studies were excluded because of duplicate data [24][25][26][27][28][29].…”

Section: Statistical Analysesmentioning

confidence: 99%

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

Tan

Deng

Lin

et al. 2019

International Journal of Hyperthermia

101

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Background: Microwave ablation (MWA) has several advantages over radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). We aimed to compare the efficacy and safety of MWA with those of RFA for HCC from the perspectives of percutaneous and laparoscopic approaches. Methods: PubMed/MEDLINE, Embase, the Cochrane library, and China Biology Medicine databases were searched. Studies comparing the efficacy and safety of MWA with those of RFA in patients with HCC were considered eligible. Complete ablation (CA), local recurrence (LR), disease-free survival (DFS), overall survival (OS), and the major complication rate were compared between MWA and RFA. Results: Four randomized controlled trials and 10 cohort studies were included. For percutaneous ablation, no significant difference was found between MWA and RFA regarding CA, LR, DFS, OS, and the major complication rate. A subgroup analysis of tumors measuring !3 cm revealed no difference in CA and LR for percutaneous ablation. For laparoscopic ablation, a significantly lower LR rate and a non-significant trend toward a higher major complication rate were observed for the MWA group (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.16-4.02, p ¼ .01 for LR; OR 0.21, 95% CI 0.04-1.03, p ¼ .05 for major complication rate). CA, DFS, and OS were similar between the two groups. Conclusions: Percutaneous (P)-MWA had similar therapeutic effects compared with P-RFA for HCC. Patients undergoing laparoscopic MWA had a lower LR rate; however, their major complication rate appeared to be higher. The superiority of MWA over RFA remains unclear and needs to be confirmed by high-quality evidence.

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Section: Statistical Analysesmentioning

confidence: 99%

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

Tan

Deng

Lin

et al. 2019

International Journal of Hyperthermia

101

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“…In accordance with inclusion and exclusion criteria, 26 studies with 4396 patients were finally enrolled. [ 25 – 27 , 11 , 28 , 13 , 29 – 36 , 14 , 37 – 43 , 12 , 44 – 46 ] The flowchart is shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Han

Yong-sheng²,

Wang³

2020

Medicine

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Background: 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. Methods: 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. Results: 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). Conclusions: 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.

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“…Secondly, a recent comparison of four different thermal ablation techniques (monopolar RFA, microwave ablation, cluster-RFA or NTM-RFA) for the management of HCC ≤5 cm abutting large vessels (defined as vessels ≥3 mm) demonstrated that overall tumor local progression was significantly higher in nodules treated by single-applicator ablation techniques (monopolar RFA or microwave ablation) when compared to nodules treated by multi-applicator techniques (cluster-RFA or NTM-RFA). 4 This demonstrates the interest of placing probes at the tumor periphery, which offers the possibility of delivering a high amount of energy close to the vessels, thus limiting the heat-sink phenomenon.…”

Section: To the Editormentioning

confidence: 97%

“…These technical advances in the treatment of HCC during the recent decade could provide better clinical outcomes by accurately targeting the index tumor, with RF device development also resulting in a larger ablation zone. 4,5 However, more prospective multicenter studies are needed to assess whether these new techniques for RFA translate into better clinical outcomes compared to surgical resection (SR) in patients with HCC.…”

Section: To the Editormentioning

confidence: 99%

Influence of ablation technique on treatment failure for perivascular hepatocellular carcinoma

Mohkam

Rode

Mabrut

2018

Journal of Hepatology

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Hepatocellular carcinoma abutting large vessels: comparison of four percutaneous ablation systems

Abstract: Multi-applicator RFA provides better local tumour control in HCC abutting large vessels than single-applicator techniques (monopolar RFA or MWA).

Cited by 28 publications

References 44 publications

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis

Radiofrequency ablation versus microwave ablation for early stage hepatocellular carcinoma

Influence of ablation technique on treatment failure for perivascular hepatocellular carcinoma

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