OBJECTIVE: This meta-analysis aims to evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) located at specific anatomical sites of the liver compared with non-specific sites. METHODS: A systematic search was conducted across five databases, covering literature from database inception to September 30, 2024. Eligible studies included prospective and retrospective cohorts involving ultrasound-guided percutaneous MWA for HCC. Data extraction and analysis were performed using Stata 15.1. The primary outcomes were 1-year, 3-year, and 5-year overall survival (OS) rates, complete ablation rates, and incidence of major complications. Pooled results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Nine studies involving 2,381 patients were included. Among them, 1,047 patients had HCC located at specific anatomical sites, and 1,334 at non-specific sites. The pooled ORs (95% CI) for OS at 1, 3, and 5 years were 0.89 (0.59-1.35), 0.83 (0.66-1.05), and 1.12 (0.91-1.38), respectively. The OR for complete ablation was 0.97 (0.61-1.53), and for major complications, 1.44 (0.59-3.51). CONCLUSION: Ultrasound-guided percutaneous MWA demonstrates comparable efficacy and safety for treating HCC at specific anatomical sites of the liver relative to non-specific sites, with no statistically significant differences in survival outcomes, ablation success, or complication rates.
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