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

Zesong MENG; Baokun LI; Longfei CAO; Jianfeng ZHANG; Guiying WANG

doi:10.19401/j.cnki.1007-3639.2025.10.009

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

Review | 更新时间：2025-12-31

- Microwave ablation versus hepatic resection in potentially resectable colorectal liver metastasis: a systematic review and meta-analysis
- China Oncology Vol. 35, Issue 10, Pages: 959-967(2025)
- 作者机构：
  
  1. 河北医科大学第四医院外二科，河北石家庄 050011
  2. 河北医科大学第二医院普外科，河北石家庄 050050
- 作者简介：
  
  WANG Guiying
- 基金信息：
  
  National Natural Science Foundation of China(82272909)
- DOI：10.19401/j.cnki.1007-3639.2025.10.009
  CLC： R735.3
- Received：20 November 2024，
  
  Revised：2025-04-15，
  
  Published：30 October 2025
- 稿件说明：
移动端阅览
Zesong MENG, Baokun LI, Longfei CAO, et al. 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.
DOI：

Zesong MENG, Baokun LI, Longfei CAO, et al. 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. DOI： 10.19401/j.cnki.1007-3639.2025.10.009.

摘要

结直肠癌是全球癌症死亡的第三大原因，肝切除术是治疗结直肠癌肝转移的标准方法，微波消融作为微创治疗手段，为这些患者提供了新的治疗选择，而肝切除术和微波消融治疗结直肠癌肝转移患者的临床疗效优劣尚无定论。本研究检索了包括SinoMed、PubMed、Web of Science、EMBASE、中国知网、万方等多个数据库关于肝切除术与微波消融治疗结直肠癌肝转移的对照研究，检索截至2024年9月。本研究共纳入13篇文献，包括2 057例患者。使用纽卡斯尔-渥太华量表和Jadad量表评估所纳入的文献质量，论文研究质量均较高。提取了患者术后并发症、住院时间、手术时间、住院费用以及患者总生存（overall survival，OS）率和无病生存（disease-free survival，DFS）率的数据。使用Review Manager 5.4软件进行meta分析。研究结果显示微波消融组和手术切除组患者在OS（HR=1.03；95% CI: 0.85~1.25；

=0.77）和DFS（HR=1.27；95%CI: 0.94~1.71；

=0.13）方面差异无统计学意义。在肝转移个数≤5个和肝转移瘤大小≤3 cm的亚组分析中，微波消融组与手术切除组患者在OS和DFS方面差异无统计学意义（

0.05）。微波消融组的住院时间、住院费用、手术时间和术中出血量均少于肝切除术组，且并发症发生率更低。因此对与肝转移个数≤5个和肝转移瘤大小≤3 cm的结直肠癌肝转移患者，微波消融是手术切除的有效替代方案，具有更低的治疗相关发病率。需要更多的随机对照试验和队列研究来进一步验证这些发现。本Meta分析在PROSPERO平台注册号为CRD42024610278。

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 we

re 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

=0.77) and DFS (HR=1.27

95% CI: 0.94-1.71

=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 (

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.

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references

SIEGEL R L , MILLER K D , WAGLE N S , et al . Cancer statistics, 2023 [J ] . CA A Cancer J Clin , 2023 , 73 ( 1 ): 17 - 48 .

KITSEL Y , COOKE T , SOTIRCHOS V , et al . Colorectal cancer liver metastases: genomics and biomarkers with focus on local therapies [J ] . Cancers (Basel) , 2023 , 15 ( 6 ): 1679 . DOI: 10.3390/cancers15061679 http://doi.org/10.3390/cancers15061679 https://www.mdpi.com/2072-6694/15/6/1679 https://www.mdpi.com/2072-6694/15/6/1679

MORRIS V K , KENNEDY E B , BAXTER N N , et al . Treatment of metastatic colorectal cancer: ASCO guideline [J ] . J Clin Oncol , 2023 , 41 ( 3 ): 678 - 700 .

SHAMSEER L , MOHER D , CLARKE M , et al . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation [J ] . BMJ , 2015 , 350 : g7647 .

BODE H , IVENS B , BSCHOR T , et al . Association of hypothyroidism and clinical depression: a systematic review and meta-analysis [J ] . JAMA Psychiatry , 2021 , 78 ( 12 ): 1375 - 1383 . DOI: 10.1001/jamapsychiatry.2021.2506 http://doi.org/10.1001/jamapsychiatry.2021.2506

SONG P Y , SHENG L J , SUN Y H , et al . The clinical utility and outcomes of microwave ablation for colorectal cancer liver metastases [J ] . Oncotarget , 2017 , 8 ( 31 ): 51792 - 51799 . DOI: 10.18632/oncotarget.15244 http://doi.org/10.18632/oncotarget.15244

邹明慧 . 腹腔镜下结直肠癌切除联合肝转移瘤微波消融术治疗大肠癌合并肝转移瘤的临床疗效 [J ] . 中国现代药物应用 , 2020 , 14 ( 13 ): 71 - 73 .

ZOU M H . Clinical efficacy of laparoscopic resection of colorectal cancer combined with microwave ablation of liver metastases in the treatment of colorectal cancer complicated with liver metastases [J ] . Chin J Mod Drug Appl , 2020 , 14 ( 13 ): 71 - 73 .

HU Y R , YANG Z W , SUN Y S . Analysis of the feasibility of microwave ablation for colorectal liver metastases: a preliminary report [J ] . Wideochir Inne Tech Maloinwazyjne , 2020 , 15 ( 1 ): 30 - 35 .

许世磊 , 胡昆鹏 , 黄河 , 等 . 微创外科治疗结直肠癌肝转移瘤的疗效分析 [J ] . 中华医学杂志 , 2015 , 95 ( 40 ): 3289 - 3292 .

XU S L , HU K P , HUANG H , et al . Effect of laparoscopic hepatectomy and microwave ablation for colorectal liver metastases [J ] . Natl Med J China , 2015 , 95 ( 40 ): 3289 - 3292 .

王绥能 , 梁贤文 , 彭勃 , 等 . 倾向性评分匹配法比较手术切除与微波消融治疗结直肠癌肝转移疗效 [J ] . 武汉大学学报(医学版) , 2019 , 40 ( 1 ): 55 - 60 .

WANG S N , LIANG X W , PENG B , et al . Comparison of surgical resection and microwave ablation in the treatment of liver metastasis of colorectal cancer by propensity score matching method [J ] . Med J Wuhan Univ , 2019 , 40 ( 1 ): 55 - 60 .

黄哲 , 李开艳 , 周萍萍 , 等 . 结直肠癌肝转移超声引导下经皮微波消融与手术切除疗效的对比分析 [J ] . 中华医学杂志 , 2020 , 100 ( 9 ): 696 - 701 .

HUANG Z , LI K Y , ZHOU P P , et al . Comparative study of ultrasound-guided percutaneous microwave ablation and surgical resection for colorectal cancer with liver metastasis [J ] . Natl Med J China , 2020 , 100 ( 9 ): 696 - 701 .

韩磊 , 武雪亮 , 郭飞 , 等 . 微波消融在潜在可切除的结直肠癌伴同时性多发肝转移中的临床应用 [J ] . 中国医学科学院学报 , 2024 , 46 ( 2 ): 161 - 168 . DOI: 10.3881/j.issn.1000-503X.15900 http://doi.org/10.3881/j.issn.1000-503X.15900

HAN L , WU X L , GUO F , et al . Clinical application of microwave ablation in potentially resectable colorectal cancer with simultaneously multiple liver metastases [J ] . Acta Acad Med Sin , 2024 , 46 ( 2 ): 161 - 168 . DOI: 10.3881/j.issn.1000-503X.15900 http://doi.org/10.3881/j.issn.1000-503X.15900

王超 , 曹爱玲 , 乐玲 . 手术切除与经皮微波消融治疗结直肠癌肝转移瘤的效果与生活质量研究 [J ] . 中外医学研究 , 2019 , 17 ( 10 ): 41 - 43 .

WANG C , CAO A L , LE L . Study on the effect and quality of life of surgical resection and percutaneous microwave ablation in the treatment of liver metastases from colorectal cancer [J ] . Chin Foreign Med Res , 2019 , 17 ( 10 ): 41 - 43 .

陈景熙 , 周彦明 , 苏旭 , 等 . 经皮B超联合腹腔镜引导微波消融同期治疗结直肠肝转移癌的效果分析 [J ] . 中外医学研究 , 2020 , 18 ( 7 ): 8 - 10 .

CHEN J X , ZHOU Y M , SU X , et al . Therapeutic effect of percutaneous B-ultrasound combined with laparoscopy-guided microwave ablation for colorectal liver metastases [J ] . Chin Foreign Med Res , 2020 , 18 ( 7 ): 8 - 10 .

TINGUELY P , DAL G , BOTTAI M , et al . Microwave ablation versus resection for colorectal cancer liver metastases-a propensity score analysis from a population-based nationwide registry [J ] . Eur J Surg Oncol , 2020 , 46 ( 3 ): 476 - 485 . DOI: 10.1016/j.ejso.2019.12.002 http://doi.org/10.1016/j.ejso.2019.12.002 https://linkinghub.elsevier.com/retrieve/pii/S0748798319314957 https://linkinghub.elsevier.com/retrieve/pii/S0748798319314957

李兴华 . 微波消融与手术切除结直肠癌肝转移疗效比较 [J ] . 吉林医学 , 2017 , 38 ( 6 ): 1092 - 1093 .

LI X H . Comparison of microwave ablation and surgical resection of liver metastasis from colorectal cancer [J ] . Jilin Med J , 2017 , 38 ( 6 ): 1092 - 1093 .

SHIBATA T , NIINOBU T , OGATA N , et al . Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma [J ] . Cancer , 2000 , 89 ( 2 ): 276 - 284 .

TINGUELY P , RUITER S J S , ENGSTRAND J , et al . A prospective multicentre trial on survival after Microwave Ablation VErsus Resection for Resectable Colorectal liver metastases (MAVERRIC) [J ] . Eur J Cancer , 2023 , 187 : 65 - 76 . DOI: 10.1016/j.ejca.2023.03.038 http://doi.org/10.1016/j.ejca.2023.03.038

ZHANG C , WANG X Y , ZUO J L , et al . Localization and density of tertiary lymphoid structures associate with molecular subtype and clinical outcome in colorectal cancer liver metastases [J ] . J Immunother Cancer , 2023 , 11 ( 2 ): e006425 . DOI: 10.1136/jitc-2022-006425 http://doi.org/10.1136/jitc-2022-006425 https://jitc.bmj.com/lookup/doi/10.1136/jitc-2022-006425 https://jitc.bmj.com/lookup/doi/10.1136/jitc-2022-006425

LONG L , XIONG W , LIN F W , et al . Regulating lactate-related immunometabolism and EMT reversal for colorectal cancer liver metastases using shikonin targeted delivery [J ] . J Exp Clin Cancer Res , 2023 , 42 ( 1 ): 117 . DOI: 10.1186/s13046-023-02688-z http://doi.org/10.1186/s13046-023-02688-z

LI J M , LIU G J , XIE X Y , et al . Outcomes following different thermal ablation strategies in patients with unresectable colorectal liver metastases [J ] . Radiology , 2023 , 308 ( 2 ): e223135 . DOI: 10.1148/radiol.223135 http://doi.org/10.1148/radiol.223135 http://pubs.rsna.org/doi/10.1148/radiol.223135 http://pubs.rsna.org/doi/10.1148/radiol.223135

GÖRGEC B , HANSEN I S , KEMMERICH G , et al . MRI in addition to CT in patients scheduled for local therapy of colorectal liver metastases (CAMINO): an international, multicentre, prospective, diagnostic accuracy trial [J ] . Lancet Oncol , 2024 , 25 ( 1 ): 137 - 146 . DOI: 10.1016/S1470-2045(23)00572-7 http://doi.org/10.1016/S1470-2045(23)00572-7

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