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Review
. 2024 Mar 28:14:1370390.
doi: 10.3389/fonc.2024.1370390. eCollection 2024.

Repeat hepatectomy versus thermal ablation therapy for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Renhua Dong #  1 , Ting Zhang #  2 , Wenwu Wan  1 , Hao Zhang  1
Affiliations
Review

Repeat hepatectomy versus thermal ablation therapy for recurrent hepatocellular carcinoma: a systematic review and meta-analysis

Renhua Dong et al. Front Oncol. .

Abstract

Background: This meta-analysis was conducted to assess the survival benefits of repeat hepatectomy (RH) and thermal ablation therapy (TAT) in managing recurrent hepatocellular carcinoma (HCC).

Methods: A comprehensive search was conducted in the PubMed, SinoMed, Embase, Cochrane Library, Medline, and Web of Science databases using relevant keywords to identify all studies published on this specific topic. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were estimated using a fixed-effects model.

Results: This meta-analysis included a total of 21 studies, comprising 2580 patients with recurrent HCC, among whom 1189 underwent RH and 1394 underwent TAT. Meta-analysis results demonstrated that the RH group exhibited superior overall survival (OS) (HR=0.85, 95%CI 0.76∼0.95, P=0.004) and recurrence-free survival (RFS) (HR=0.79, 95%CI 0.7∼0.9, P<0.01) compared to the TAT group. Regarding postoperative complications, the TAT group experienced fewer complications than the RH group (OR=3.23, 95%CI 1.48∼7.07, P=0.003), while no significant difference in perioperative mortality was observed between the two groups (OR=2.11, 95%CI 0.54∼8.19, P=0.28).

Conclusion: The present study demonstrates that, in comparison to TAT, RH may confer superior survival benefits for patients with recurrent HCC.

Keywords: meta-analysis; recurrent hepatocellular carcinoma; repeat hepatectomy; systematic review; thermal ablation therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart of the literature selection.
Figure 2
Figure 2
Forest plots of pooled data on overall survival.
Figure 3
Figure 3
Forest plots of pooled data on recurrence free survival.
Figure 4
Figure 4
Forest plots of pooled data on severe postoperative complications.
Figure 5
Figure 5
Forest plots of pooled data on mortality.
Figure 6
Figure 6
Funnel plot analysis: (A) funnel plot of overall survival; (B) funnel plot of recurrence-free survival.
See this image and copyright information in PMC

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