You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Microwave coagulation therapy for hepatocellular carcinoma.
Abstract 1:
The efficacy and safety of microwave coagulation therapy ( MCT ) in patients with hepatocellular carcinoma ( HCC ) and impaired hepatic reserve were studied . Preoperative background factors , postoperative results , and prognostic factors were compared in 51 patients who underwent hepatic resection ( HR group ) and 38 patients who underwent microwave coagulation therapy ( MCT group ) .  Before surgery , measures of hepatic function , including level of albumin ( P = 0.0072 ) , prothrombin time ( P<0.0001 ) , hepaplastin test ( P = 0.0088 ) , and the radioactivity of technetium-99 m galactosyl-human serum albumin 15 min in the liver after injection divided by that in both liver and heart ( P < 0.0001 ) were significantly lower in the MCT group than in the HR group . The indocyanine green dye retention rate at 15 min was significantly greater ( P<0.0001 ) in the MCT group than in the HR group , and a significant difference was noted in Child-Pugh grade between the groups ( P<0.0001 ) . Operative time ( P = 0.0014 ) and blood loss during surgery ( P = 0.0005 ) were significantly lower in the MCT group than in the HR group . In contrast , no significant differences were recognized between the groups in the changes in postoperative liver function , or in the rates of morbidity , mortality , local recurrence , and survival . Moreover , the type of treatment ( HR or MCT ) was not a prognostic factor . The results indicate that MCT can be used safely as an alternative to hepatic resection in patients with poor liver function without reducing the efficacy of local control


Title 2:
Comparison of percutaneous microwave ablation and laparoscopic resection in the prognosis of liver cancer.
Abstract 2:
The effect of percutaneous microwave ablation and laparoscopic resection on the prognosis of liver cancer  was investigated . Ninety patients with liver cancer treated at our hospital from March 2010 to March 2012 were divided into group A and group B ( n=45 ) by using a r and om number table , and the surgical conditions and the prognosis were compared . The surgical conditions of patients in group A were significantly better than those in group B ( P<0.05 ) . The incidence of complications in group A was 6.67 % , which was obviously lower than that of group B ( P<0.05 ) . The local recurrence rate of group A was 20.00 % , and that of group B was 8.89 % , which showed a significant difference ( P<0.05 ) . The two groups did not differ significantly in terms of either total recurrence rate ( P>0.05 ) or 1-year , 2-year and 3-year survival ( P>0.05 ) . Both percutaneous microwave ablation and laparoscopic resection had a good long-term efficacy in liver cancer . However , percutaneous microwave ablation was superior as it caused less invasiveness , reduced the incidence of complications and improved prognosis of liver cancer


Title 3:
Evaluation of intraoperative microwave coagulo-necrotic therapy (MCN) for hepatocellular carcinoma: a single center experience of 719 consecutive cases
Abstract 3:
Background Hepatic resection ( HRx ) or radiofrequency ablation may be carried out as the first-line treatment of hepatocellular carcinoma ( HCC ) . However , we have used intraoperative microwave ablation , named microwave coagulo-necrotic therapy ( MCN ) as part of our strategy for the treatment of HCCs for more than 15 years . Here we describe the treatment outcomes achieved at our institution as a high-volume center for microwave ablation . Methods Between July 1994 and December 2010 , 719 consecutive patients received MCN as their initial therapy for HCC ( mean tumor size 26.9 mm , mean number of lesions 2.51 ) at our institute . The therapeutic survival effect , local tumor progression , and overall recurrence were prospect ively evaluated and statistically analyzed . Results The 1- , 3- , 5- , 7- , and 10-year overall survival rates of all 719 patients were 97.7 , 79.8 , 62.1 , 45.3 , and 34.1 % , respectively . Thirty percent of the patients had Child – Pugh class B cirrhosis and the 5-year survival rate of these patients was 46.6 % . The 5-year survival of patients with ≥4 lesions ( n = 168 ) was 49.6 % and that of patients meeting the Milan criteria ( n = 470 ) was 70.9 % . The 1- , 3- , 5- , 7- , and 10-year overall survival rates for 390 patients treated with MCN who had ≤3 lesions with diameter ≤3 cm were 97.9 , 85.1 , 70.0 , 57.1 , and 43.0 % . No significant differences were found between the overall survival rates  after MCN and the overall survival rates in 34 patients treated with HRx during the same period at our institute and under the same ( P = 0.3592 ) , nor were there any differences in disease-free survival ( P = 0.3496 ) and local recurrence rates  between the MCN and HRx groups ( P = 0.5926 ) . Conclusion MCN is effective for the locoregional control of HCC , with results comparable to those of HRx . MCN should be considered as one of the first-choice treatments for HCC , even for patients with poor liver function or multiple lesions
Conclusion In conclusion , our meta- analysis suggests that MWA may be superior to HRN as it is as effective as HRN in terms of overall survival , disease-free survival , tumor recurrence , and is associated with shorter operation time , less amount of blood loss , and fewer complications