Microwave ablation versus radiofrequency ablation for hepatocellular carcinoma: a propensity score matching and inverse probability weighting analysis.

Background: Radiofrequency ablation (RFA) and microwave ablation (MWA) have been proven to be safe and effective methods for treating early-stage hepatocellular carcinoma (HCC). Although researchers have compared the efficacy of MWA and RFA, the results have not been consistent. Therefore, this study utilizes a large sample size and employs propensity score matching (PSM) combined with inverse probability weighting (IPW) to further investigate the effects between the two treatments.

Methods: Patients with early-stage HCC who were diagnosed and treated with MWA or RFA between 2015 and 2022 were collected. The post-treatment effects and tumor outcomes were analyzed using PSM and IPW.

Results: The 1-, 2- and 3-year recurrence rates were 40.89%, 68.07% and 84.13% for MWA, and 39.13%, 62.64% and 75.71% for RFA. The overall survival rates at 1, 2 and 3 years were 70.47%, 40.98% and 21.90% for MWA, and 70.53%, 44.85% and 30.60% for RFA. Cox regression indicated that age, tumor number and post-treatment were adverse prognostic factors for recurrence-free survival, while treatment method, age, tumor number and post-treatment were adverse prognostic factors for overall survival.

Conclusion: The 5-year overall survival rates for RFA and MWA remained similar. The discrepancies in the 5-year cumulative recurrence-free rate might be attributed to the small MWA cohort, possible differences in patient selection, the margin assessment procedure used and the overall short follow-up period.