Microwave ablation versus hepatic resection in potentially resectable colorectal liver metastasis: a systematic review and meta-analysis
Bibliographic record
Abstract
Colorectal cancer is the third leading cause of cancer-related mortality worldwide. Hepatic resection is the standard treatment for colorectal cancer liver metastasis. Microwave ablation (MWA), as a minimally invasive therapeutic approach, offers an alternative treatment option for these patients. But the clinical efficacy of hepatic resection and MWA in treating colorectal cancer liver metastasis patients is still inconclusive. Literatures were retrieved on comparative studies about the treatment of colorectal cancer liver metastasis with hepatic resection and MWA from multiple databases, including sinoMed, PubMed, Web of Science, EMBASE, CNKI, Wanfang, etc. The cutoff date of retrieval was September 2024. Finally, a total of 13 studies comprising 2 057 patients, were included in this study. The papers were assessed using the Newcastle-Ottawa Scale and Jadad Scale. All included studies were of high quality. Data extraction focused on postoperative complications, length of hospital stay, surgical duration, hospitalization costs, and patient survival outcomes, including overall survival (OS) and disease-free survival (DFS). A meta-analysis was performed using Review Manager 5.4 software. There were no significant differences in OS (HR=1.03, 95% CI: 0.85-1.25, P=0.77) and DFS (HR=1.27, 95% CI: 0.94-1.71, P=0.13) between the MWA group and the hepatic resection group. In the subgroup analysis of patients with ≤5 liver metastases and size of metastases ≤3 cm, there were no statistically significant differences in OS and DFS between the MWA group and the hepatic resection group. The MWA group exhibited shorter hospital stay, reduced hospitalization costs, decreased surgical duration, less intraoperative blood loss, and lower incidence of complications compared to the hepatic resection group (P<0.05). Therefore, for patients with colorectal liver metastases characterized by a number of liver metastases ≤5 and size of metastases ≤3 cm, MWA serves as an effective alternative to hepatic resection, with a lower morbidity associated with treatment. Further validation of these findings is warranted through additional randomized controlled trials and cohort studies. The registration number of this Meta-analysis on the PROSPERO platform is CRD42024610278.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.018 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.030 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".