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. 2021 Apr;12(2):770-780.
doi: 10.21037/jgo-21-52.

A systematic review and meta-analysis of radio frequency ablation and routine resection in the treatment of small hepatocellular carcinoma

Yu Li  1 , Weike Xiao  1 , Zhenrong Gao  1
Affiliations

A systematic review and meta-analysis of radio frequency ablation and routine resection in the treatment of small hepatocellular carcinoma

Yu Li et al. J Gastrointest Oncol. 2021 Apr.

Abstract

Background: This study sought to conduct a meta-analysis of the relevant literature on radiofrequency ablation (RFA) and routine resection in the treatment of small hepatocellular carcinoma (SHCC) in recent years, and to examine the clinical efficacy and safety of different schemes.

Methods: PubMed, The Cochrane Library, Embase, CNKI, Chinese biomedical literature, VIP Chinese journal and the Wanfang Database were used to comprehensively search for relevant papers on clinical control studies of RFA and the routine resection SHCC published between January 2008 and December 2019. The clinical efficacy and safety of different schemes in the treatment of SHCC were compared, including the overall survival rate within 1, 3, and 5 years, and the incidence of complications during treatment. A meta-analysis was undertaken using methods provided by the Cochrane Collaboration and RevMan 5.3 software.

Results: A total of 13 publications of studies were retrieved in which 2,384 patients participated. Of these patients, 1,256 (52.68%) were allocated to the RFA group and 1,128 patients (47.32%) to the conventional resection group. The effect size of the 1-year overall survival rate for the two groups was odds ratio (OR): 0.78 [95% confidence interval (CI), 0.43-1.38]; Z test: P=0.32. The effect size of the overall survival rate within 3 years was OR: 0.71 (95% CI, 0.48-1.05); Z test: P=0.07. The difference was not statistically significant. The 5-year overall survival rate of the RFA group and conventional resection group was OR: 0.55 (95% CI, 0.40-0.72). The OR value fell within the CI, excluding 1; Z test: P<0.0001. The difference was statistically significant. The incidence of complications in the RFA group during treatment was lower than that in the conventional resection group (OR: 0.45; 95% CI, 0.32-0.69). The OR value was within the CI, excluding 1; Z test: P=0.0002. The difference was statistically significant.

Conclusions: The short-term effect of RFA in the treatment of SHCC is basically the same as that of routine resection; however, the long-term effect is significantly lower than that of routine resection. RFA has a lower incidence of complications during treatment, and thus better clinical safety.

Keywords: Radiofrequency ablation (RFA); efficacy; meta-analysis; routine resection; safety; small hepatocellular carcinoma (SHCC).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jgo-21-52).The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Retrieve and selection guide flow chart.
Figure 2
Figure 2
Comparison of the overall survival rate within 1-year between the radiofrequency ablation (RFA) and conventional resection groups.
Figure 3
Figure 3
Comparison of the overall survival rate within 3 years between the radiofrequency ablation (RFA) and conventional resection groups.
Figure 4
Figure 4
Comparison of the overall survival rate within 5 years between the radiofrequency ablation (RFA) and conventional resection group.
Figure 5
Figure 5
Complication rates for patients in the radiofrequency ablation (RFA) with conventional resection groups.
See this image and copyright information in PMC

Comment in

References

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