Microwave ablation versus hepatic resection in potentially resectable colorectal liver metastasis: a systematic review and meta-analysis

doi:10.19401/j.cnki.1007-3639.2025.10.009

Abstract

Abstract:

Colorectal cancer is the third leading cause of cancer-related mortality worldwide. Hepatic resection is the standard treatment for colorectal cancer liver metastasis. Microwave ablation (MWA), as a minimally invasive therapeutic approach, offers an alternative treatment option for these patients. But the clinical efficacy of hepatic resection and MWA in treating colorectal cancer liver metastasis patients is still inconclusive. Literatures were retrieved on comparative studies about the treatment of colorectal cancer liver metastasis with hepatic resection and MWA from multiple databases, including sinoMed, PubMed, Web of Science, EMBASE, CNKI, Wanfang, etc. The cutoff date of retrieval was September 2024. Finally, a total of 13 studies comprising 2 057 patients, were included in this study. The papers were assessed using the Newcastle-Ottawa Scale and Jadad Scale. All included studies were of high quality. Data extraction focused on postoperative complications, length of hospital stay, surgical duration, hospitalization costs, and patient survival outcomes, including overall survival (OS) and disease-free survival (DFS). A meta-analysis was performed using Review Manager 5.4 software. There were no significant differences in OS (HR=1.03, 95% CI: 0.85-1.25, P=0.77) and DFS (HR=1.27, 95% CI: 0.94-1.71, P=0.13) between the MWA group and the hepatic resection group. In the subgroup analysis of patients with ≤5 liver metastases and size of metastases ≤3 cm, there were no statistically significant differences in OS and DFS between the MWA group and the hepatic resection group. The MWA group exhibited shorter hospital stay, reduced hospitalization costs, decreased surgical duration, less intraoperative blood loss, and lower incidence of complications compared to the hepatic resection group (P<0.05). Therefore, for patients with colorectal liver metastases characterized by a number of liver metastases ≤5 and size of metastases ≤3 cm, MWA serves as an effective alternative to hepatic resection, with a lower morbidity associated with treatment. Further validation of these findings is warranted through additional randomized controlled trials and cohort studies. The registration number of this Meta-analysis on the PROSPERO platform is CRD42024610278.

Key words: Colorectal cancer liver metastasis, Hepatic resection, Microwave ablation, Patient survival, Postoperative complications, Meta-analysis

CLC Number:

R735.3

MENG Zesong, LI Baokun, CAO Longfei, ZHANG Jianfeng, WANG Guiying. Microwave ablation versus hepatic resection in potentially resectable colorectal liver metastasis: a systematic review and meta-analysis[J]. China Oncology, 2025, 35(10): 959-967.

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