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Meta-Analysis
. 2017 Jul 10;15(1):126.
doi: 10.1186/s12957-017-1196-2.

Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis

Wen Luo  1 , Yunfei Zhang  2 , Guangbin He  1 , Ming Yu  1 , Minjuan Zheng  1 , Liwen Liu  3 , Xiaodong Zhou  3
Affiliations
Meta-Analysis

Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis

Wen Luo et al. World J Surg Oncol. .

Abstract

Background: Percutaneous ablation has quickly arisen as one of the important alternative treatments for hepatocellular carcinoma (HCC). We aimed to compare the therapeutic effects of radiofrequency ablation (RFA) and other ablative techniques on HCCs.

Methods: Databases were searched to identify literature on complete tumor ablation (CTA), overall survival (OS), local tumor recurrence (LTR), and complications of RFA in the treatment of HCC, compared with those of microwave ablation (MWA), percutaneous ethanol injection (PEI), PEI plus RFA, cryoablation (CRA), laser ablation (LSA), and high-intensity focused ultrasound. Randomized controlled trials and high-quality cohort studies were included in the assessment.

Results: The effects of MWA and CRA appeared to be similar to those of RFA, but lower rates of LTR and higher rates of CTA in large tumors compared with RFA were reported (P < 0.05). CTA rates were lower in patients treated with PEI (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.06-0.42), and higher in those treated with PEI plus RFA (OR 2.28, 95% CI 1.19-3.60), with an increased incidence of fever (P < 0.05). LSA resulted in lower CTA rates (OR 0.32, 95% CI 0.13-0.81) and OS (hazard ratio 1.47, 95% CI 1.01-2.15), with a lower incidence of complications.

Conclusions: Compared with RFA, identical effects were found in MWA and CRA groups. Fewer complications were observed in PEI and LSA group. PEI plus RFA appeared more effective, with a higher rate of complications. Well-designed randomized controlled trials are further needed to confirm above results.

Keywords: Ablative techniques; Hepatocellular carcinoma; Radiofrequency ablation; Therapeutic effects.

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Ethics approval and consent to participate

No applicable.

Consent for publication

The written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flowchart of articles search
Fig. 2
Fig. 2
Methodological quality summary of randomized controlled trials. a Risk of bias graph. b Risk of bias summary
Fig. 3
Fig. 3
Forest plot of pooled rates of completed tumor ablation after radiofrequency ablation (RFA) and other techniques. a Microwave ablation (MWA) versus RFA in cohort studies. b MWA versus RFA in randomized studies. c Percutaneous ethanol injection (PEI) versus RFA in randomized studies. d PEI versus RFA in cohort studies
Fig. 4
Fig. 4
Forest plot of pooled rates of fever in the microwave ablation group and the radiofrequency ablation group
Fig. 5
Fig. 5
Forest plot of pooled rates of completed tumor ablation after radiofrequency ablation (RFA) and othertechniques. a Percutaneous ethanol injection plus RFA versus RFA. b Cryoablation versus RFA c Laser ablation versus RFA
Fig. 6
Fig. 6
Funnel plot of pooled data. a completed tumor ablation between the microwave ablation (MWA) group and the radiofrequency ablation (RFA) group. b local tumor recurrence between the MWA group and the RFA group. c overall survival between the percutaneous ethanol injection group and the RFA group
See this image and copyright information in PMC

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