Cryoablation versus microwave ablation in the treatment of hepatocellular carcinoma: A Systematic Review and meta-analysis

To evaluate the efficacy and safety of cryoablation (CRA) versus microwave ablation (MWA) for hepatocellular carcinoma (HCC). The PubMed, Embase, Cochrane Library, CNKI, Wan Fang and VIP databases were searched to obtain all related studies on CRA and MWA from the inception dates to July 2022. The Meta-analysis was performed by the RevMan5.3 software. Five studies comparing CRA with MWA were eligible and 470 HCC patients were included in the analysis. No statistically significant differences in complete ablation rate (OR = 1.17, 95 % CI: 0.36-3.79, P > 0.05), local recurrence rate (OR = 0.25, 95 % CI: 0.05-1.29, P = 0.10), 1-year survival rate (OR = 2.07, 95 % CI: 0.89-4.79, P > 0.05) and postoperative decreased value of AFP (MD = -1.63, 95 % CI: -83.13-79.87, P > 0.05) were observed; however, CRA was associated with a significantly lower major complication rate (OR = 0.06, 95 % CI: 0.01-0.31, P < 0.05) compared with MWA. CRA had comparable outcomes to MWA in terms of complete ablation, local recurrence, 1-year survival and postoperative reduced AFP, meanwhile, CRA demonstrated favorable safety, and CRA may be a recommended ablation treatment for HCC. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).