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A meta-analysis and systematic review of the comparison of laparoscopic ablation to percutaneous ablation for hepatic malignancies

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Abstract

Background

The optimal access for thermal ablation of the liver has not been evaluated in the literature for the laparoscopic versus percutaneous techniques. The aim of this manuscript was to determine the optimal ablation technique and patient selection for hepatic malignancies by comparing the efficacy and recurrence-free survival of laparoscopic and percutaneous thermal ablation.

Methods

A detailed literature search was made in PubMed, Web of Science, Google scholar, and EMBASE for related research publications. The data were extracted and assessed by two reviewers independently. Analysis of pooled data was performed, and Odds Ratio (OR) or Hazard Ratio (HR) with corresponding confidence intervals (CIs) was calculated and summarized respectively.

Results

A total of 10 articles were included with 1916 ablation patients. Laparoscopic ablation success (Median 100%) was found to be higher than percutaneous ablation success (median 89.4%) (p = ns). There was a higher percentage of both local and non-local hepatic recurrence in the patients treated with percutaneous ablation versus laparoscopic ablation. Meta-analysis indicated no difference in the adjusted hazard rate of recurrence by procedure type (p = 0.94). Laparoscopic ablation had a higher percentage of complications compared to percutaneous ablation (median lap 14.5% vs. perc 3.3%).

Conclusions

While laparoscopic and percutaneous ablation are both effective interventions for hepatic malignancies, laparoscopic ablation was found to have improved ablation success and less local and non-local hepatic recurrence compared to percutaneous ablation.

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Data availability

The datasets supporting the conclusions of this article are included within the article.

Abbreviations

HCC:

Hepatocellular carcinoma

MWA:

Microwave ablation

RFA:

Radiofrequency ablation

AZ:

Ablation zone

CT:

Computerized tomography

MRI:

Magnetic resonance imaging

CI:

Confidence interval

HR:

Hazard ratio

OR:

Odds ratio

RCTs:

Randomized controlled trials)

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Funding

The authors have no financial support to declare.

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, 315 E. Broadway M10, Louisville, KY, 40202, USA

    Joslin R. Musick & Robert C. G. Martin

  2. Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA

    Jeremy T. Gaskins

Authors
  1. Joslin R. Musick
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  2. Jeremy T. Gaskins
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  3. Robert C. G. Martin
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Contributions

RM designed the research process. JM searched the database for corresponding articles. JM extracted useful information from the articles above. JG performed the meta-analysis. JM drafted the systematic review. All authors had read and approved the manuscript and ensured that this was the case.

Corresponding author

Correspondence to Robert C. G. Martin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study did not require ethical approval since it was a review of published articles and did not directly involve the use of human or animal subjects.

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Supplementary Information

Below is the link to the electronic supplementary material.

10147_2023_2304_MOESM1_ESM.tiff

Supplementary file1 Figure 1 Forest plot with meta-analysis with all articles included of (a) ablation success (b) local recurrence, and (c) complications (TIFF 6328 KB)

Supplementary file2 (TIFF 6328 KB)

Supplementary file3 (TIFF 6328 KB)

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Musick, J.R., Gaskins, J.T. & Martin, R.C.G. A meta-analysis and systematic review of the comparison of laparoscopic ablation to percutaneous ablation for hepatic malignancies. Int J Clin Oncol 28, 565–575 (2023). https://doi.org/10.1007/s10147-023-02304-2

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  • DOI: https://doi.org/10.1007/s10147-023-02304-2

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