Complication Rates and Risk of Recurrence After Percutaneous Radiofrequency Ablation and Microwave Ablation for the Treatment of Liver Tumors: a Meta-analysis

Ayman S Alhasan; Tareef S Daqqaq; Mustafa S Alhasan; Hadeel A Ghunaim; Mervat Aboualkheir

doi:10.1016/j.acra.2023.11.005

Complication Rates and Risk of Recurrence After Percutaneous Radiofrequency Ablation and Microwave Ablation for the Treatment of Liver Tumors: a Meta-analysis

Acad Radiol. 2024 Apr;31(4):1288-1301. doi: 10.1016/j.acra.2023.11.005. Epub 2023 Dec 11.

Authors

Ayman S Alhasan¹, Tareef S Daqqaq², Mustafa S Alhasan², Hadeel A Ghunaim², Mervat Aboualkheir³

Affiliations

¹ Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.); Department of Radiology, King Faisal Specialist Hospital and Research Centre, Madinah, Saudi Arabia (A.S.A.). Electronic address: ahasan@taibahu.edu.sa.
² Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.).
³ Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, Saudi Arabia (A.S.A., T.S.D., M.S.A., H.A.G., M.A.); Department of Clinical Science /College of Medicine/Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia (M.A.).

PMID: 38087720
DOI: 10.1016/j.acra.2023.11.005

Abstract

Rationale and objectives: The rate of complications and risk of local recurrence following percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) for liver tumors varies significantly between investigations. This meta-analysis aimed to assess complication rates and risk of local recurrence after percutaneous RFA and MWA.

Materials and methods: PubMed, Medline, Web of Science, the Cochrane Library, Embase, Google Scholar, and CINAHL were systematically searched from database inception until August 2022 to retrieve articles reporting the complication rates and risk of recurrence after percutaneous RFA and MWA for the treatment of liver tumors. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated and displayed by forest plots. To measure heterogeneity, Cochran Q and I² statistics were also applied. Egger's test and funnel plots were also performed to assess any potential publication bias. Additionally, subgroup analysis was done to investigate the source of heterogeneity.

Results: 26 studies including 2026 and 1974 patients for RFA and MWA, respectively, were included. The rate of minor complications was significantly higher after MWA compared to RFA, yielding an overall OR of 0.688 (95% CI: 0.549-0.862, P = 0.001). Similarly, the rate of major complications was significantly higher after MWA than RFA (P = 0.012), yielding an overall OR of 0.639 (95% CI: 0.450-0.907). No significant difference was found between RFA and MWA in terms of local recurrence after ablation (P > 0.05). In addition, there was no statistical evidence of publication bias.

Conclusion: When most factors are considered equally, percutaneous RFA and MWA can be considered safe modalities for the treatment of liver tumors, with RFA superior in terms of the incidence of minor and major complications.

Keywords: Liver tumors; Microwave ablation; Radiofrequency ablation.

Publication types

Systematic Review
Meta-Analysis

MeSH terms

Carcinoma, Hepatocellular* / therapy
Catheter Ablation* / adverse effects
Humans
Liver Neoplasms* / therapy
Microwaves / therapeutic use
Radiofrequency Ablation* / adverse effects
Retrospective Studies
Treatment Outcome