Effectiveness of microwave ablation for the treatment of hepatic hemangioma - meta-analysis and meta-regression

Abstract

Background

The treatment of hepatic hemangioma includes surgical resection, radiofrequency ablation and Transarterial embolization. However, complications, mortality and compromised effectiveness limit their applications. Microwaves with effective heating generation and short ablation time become a promising treatment. The aim of this study is to conduct systematic review and meta-analyses to evaluate the effectiveness of Microwave Ablation (MWA) for the treatment of hepatic hemangioma.

Methods

A systematic literature review was conducted in PubMed. Main outcomes were defined as hemangioma decreases in diameters and volume changes post-MWA. Conventional random-effect meta-analysis technique was applied to analyze the pooled data, and meta-regression model was established to explore the association among factors.

Results

There were nine studies with a total of 501 patients retrieved. The pooled estimate of mean differences and 95% CI of hemangioma decreases after MWA treatment in diameter and in volume change (%) were 3.009 cm and (1.856, 4.161), and 53.169% and (51.274, 55.065), respectively. The pooled estimates of liver enzyme, ALT and AST, elevation were 219.905 with 95%CI (160.860, 278.949) and 315.679 with 95%CI (226.961, 404.397), respectively. Major complications were defined as acute kidney injury (AKI), pleural effusion, diaphragmatic hernia, and jaundice that needed to be treated, and the pooled incidence was 0.017 with 95% CI of (0.006, 0.029). No mortality related to MWA was reported. Meta-regression showed ablation time was associated with pre-operative lesion size (p = .001).

Conclusion

MWA is effective and safe in treatment of hepatic hemangioma, and our study suggests that hemangioma size should be investigated in the future MWA pretreatment difficulty scoring system study.

Keywords:

• Hepatic hemangioma treatment
• microwave ablation
• hepatic benign tumor
• effectiveness
• hemangioma size

Ethical approval

We declare that there are no studies with human participants or animals performed by any of the authors in this article.

Author contributions

LI FEI is the first author and responsible for the manuscript writing and data analyses; XING Hongsong is the corresponding author and designed the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study is supported by the project of Evaluation of Various Treatment to Giant Hemangioma based on Hepatectomy Difficulty Scoring System from Health and Family Planning Commission of Wuhan Municipality (Grant No. WX21Z09).