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SIR 2025

Interventional Oncology

Traditional Poster

Session: Traditional Poster Presentations

49 - Microwave Ablation Versus Resection for Colorectal Cancer Liver Metastases: A Systematic Review and Meta-Analysis

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: The purpose of this study was to assess the available evidence comparing the clinical outcomes and safety of microwave ablation (MWA) versus surgical resection for colorectal liver metastases (CRLM) through a systematic review and meta-analysis.

Materials and Methods: A systematic search was conducted through PubMed, Embase, Google Scholar, Cochrane (CENTRAL), and ClinicalTrials.gov using keywords to identify relevant studies. Case reports, commentaries, non-human research, duplicates, and studies lacking data on MWA, or surgical resection were excluded. Following a full-text review of the remaining studies, 9 were deemed eligible. A double-arm meta-analysis was conducted using a random-effects model to pool event data from both the intervention (MWA, MWA + resection) and comparison (resection) groups and calculate risk ratios (RRs). The primary outcome was overall survival (OS), while secondary outcomes included overall complication rates, major (Clavien-Dindo grade ≥3) complications, and recurrence rates. A leave-one-out sensitivity analysis was done to assess the effects of individual studies on the overall results. R version 4.4.1 was used for all analyses, with statistical significance set at 0.05. This review adhered to PRISMA guidelines {1], and is registered with PROSPERO.

Results: Of the 9 included studies, a total of 1,150 patients were analyzed, with 484 in the intervention group (MWA and MWA + resection) and 666 in the resection-only comparison group. OS rates did not differ significantly between the two groups at 1 year (RR: 0.99, 95% CI, 0.95-1.03; p = 0.49), 2 years (RR: 0.98, 95% CI, 0.90-1.06; p = 0.54), or 3 years (RR: 1.03, 95% CI, 0.92-1.14; p = 0.55). Similarly, recurrence rate (RR: 1.28; p = 0.27, I2 = 85%), overall complications rate (RR: 0.65; P = 0.19; I2 = 85%) and major complications rate (RR: 0.38; p = 0.07; I2 = 54%) had no statistical difference among the two arms. However, the data was heterogeneous, which was rectified using sensitivity analysis that strengthened the association of MWA with fewer overall complications (RR: 0.54, 95% CI, 0.31-0.94; p = 0.03, I² = 33%) and fewer major complications (RR: 0.28, 95% CI: 0.11–0.74; p = 0.02, I² = 0%).

Conclusion: The sensitivity analysis revealed that MWA is associated with fewer overall and major complications compared to surgical resection, indicating it may be a safer alternative for CRLM. However, the heterogeneity of the studies and relatively small sample size limit the generalizability of these results. Larger, randomized controlled trials are needed to validate these findings and refine treatment strategies.