Microwave ablation for liver metastases from colorectal cancer: A comprehensive review of clinical efficacy and safety

Table 1 Summary of clinical outcomes and safety in studies comparing microwave ablation with other ablation techniques for colorectal liver metastases

Ref.	Modality	Follow-up (months)	Complication rate (%)	Local recurrence rate (%)	Overall survival (months)	Disease-free survival (months)
Di Martino et al[18], 2020	MWA vs RFA	36	7	8 (MWA); 12 (RFA)	44.5	38.5
Gavriilidis et al[19], 2021	MWA vs RFA vs HR	36	12	5	32.1	24.5
Mimmo et al[2], 2022	MWA	60	10	6	34.3	22
Tinguely et al[4], 2023	MWA vs HR	60	15	7	58	28
Ammori et al[15], 2013	HAI chemotherapy	60	16	18	47	25
Izzo et al[8], 2019	RFA vs MWA	66	10.5	7.9	50	22
Lucchina et al[14], 2016	MWA	12	10	6	32	18
Meloni et al[16], 2017	MWA	36	15	5.2	24	24
Vogl et al[17], 2017	MWA	36	5	5.2	32	24
Carrafiello et al[29], 2008	MWA	12	5	6	36	12
Cornelis et al[36], 2017	MWA	60	5	6	32	18
Facciorusso et al[32], 2020	MWA vs RFA	39	7	4.3 (MWA); 7.5 (RFA)	39	22
Moussa et al[40], 2019	MWA	24	8	5	24	24
Spiliotis et al[41], 2021	MWA vs RFA	24	12	6	24	24
Tan et al[38], 2019	MWA vs RFA	24	6	12 (MWA); 15 (RFA)	24	24
Vietti Violi et al[39], 2018	MWA vs RFA	24	12	12 (MWA); 14 (RFA)	24	24
Zheng et al[42], 2018	TACE vs TACE + MWA	45	17	6	17.1	6.7

This table provides a comprehensive overview of the clinical outcomes and safety across various studies that evaluated microwave ablation in comparison with other ablation techniques such as radiofrequency ablation, hepatic resection, and other modalities. The table summarizes key metrics, including the follow-up duration, complication rates, local recurrence rates, overall survival, and disease-free survival. These metrics highlight the relative effectiveness and safety profiles of microwave ablation and its potential advantages or limitations in the treatment of colorectal liver metastases. MWA: Microwave ablation; RFA: Radiofrequency ablation; HR: Hepatic resection; HAI: Hepatic artery infusion; TACE: Transarterial chemoembolization.

Table 2 Advantages and disadvantages of microwave ablation compared with other ablation techniques

Ref.	Modality	Advantages	Disadvantages
Carrafiello et al[29], 2008	MWA vs other ablation techniques	Higher intratumoral temperatures, larger ablation zones, less heat-sink effect	Requires further studies to confirm long-term effectiveness
Cornelis et al[36], 2017	MWA vs RFA	Less dependent on electrical conductivities, higher temperatures, less desiccation	Insufficient long-term data on oncologic effectiveness
Facciorusso et al[32], 2020	MWA vs RFA	Broader zone of active heating, higher temperatures, shorter treatment times, no heat-sink effect	Broader and less predictable necrosis areas, uncertain if larger ablation zone translates to survival gain
Moussa et al[40], 2019	MWA vs RFA	Overcomes limitations of RFA in lung cancer treatment, higher temperatures, larger ablation zones	Potential complications, need for optimal patient selection
Spiliotis et al[41], 2021	MWA vs RFA	Better oncological outcomes in terms of local tumor progression for HCC	Requires high-quality evidence to confirm superiority
Tan et al[38], 2019	MWA vs RFA	Lower local recurrence rates in laparoscopic ablation	Higher major complication rate in laparoscopic MWA
Vietti Violi et al[39], 2018	MWA vs RFA	Low local tumor progression rates, fewer complications	No significant difference in complications between MWA and RFA
Zheng et al[42], 2018	MWA vs TACE	Improved overall survival, longer time to progression	Higher recurrence rates, potential complications
Ammori et al[15], 2013	HAI chemotherapy vs R/A	Increased conversion to resection/ablation, improved long-term survival	Only 25% of patients respond sufficiently for conversion
Gavriilidis et al[19], 2021	MWA vs HR vs RFA	Less local recurrence, better 3-year and 5-year survival	Significantly younger patients, lower preoperative CEA
Lucchina et al[14], 2016	MWA vs RFA	Higher thermal efficiency, no heat-sink effect, suitable for tumors near vessels	Requires further validation for widespread use
Meloni et al[16], 2017	MWA vs other ablation techniques	High efficacy, fast procedure, good local control	Requires advanced imaging and close follow-up
Mimmo et al[2], 2022	MWA	High local control rates, long-term disease control	Requires optimal patient selection and proper procedural techniques
Tinguely et al[4], 2023	MWA vs HR	Non-inferior overall survival compared to resection, lower complications	Higher retreatment rates compared to resection
Vogl et al[17], 2017	MWA	Shorter ablation time, less pain, less heat sink effect	Needs scientific proof of advantages
Wagstaff et al[46], 2014	MWA vs RFA	Similar oncologic outcomes, better functional and perioperative outcomes	Low risk of residual disease, candidates must be properly informed

This table summarizes the advantages and disadvantages of microwave ablation (MWA) compared to other ablation techniques such as radiofrequency ablation, hepatic arterial infusion, and transarterial chemoembolization. The table highlights the specific benefits of MWA, such as higher intratumoral temperatures, larger ablation zones, and reduced heat-sink effects, and potential drawbacks such as the need for further studies to confirm its long-term effectiveness and higher complication rates in certain contexts. This comparison provides insights into the suitability of MWA for treating colorectal liver metastases and helps understand its role relative to other established therapies. MWA: Microwave ablation; RFA: Radiofrequency ablation; HCC: Hepatocellular carcinoma; TACE: Transarterial chemoembolization; HAI: Hepatic artery infusion; R/A: Resection/ablation; HR: Hepatic resection; CEA: Carcinoembryonic antigen.