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- Title
Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma.
- Authors
Zhou Y; Zhao Y; Li B; Xu D; Yin Z; Xie F; Yang J; Zhou, Yanming; Zhao, Yanfang; Li, Bin; Xu, Donghui; Yin, Zhengfeng; Xie, Feng; Yang, Jiamei
- Abstract
<bold>Background: </bold>There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)] for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence.<bold>Methods: </bold>Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from 1997 to 2009 in PubMed and Medline. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.<bold>Results: </bold>One randomized controlled trial, and 9 nonrandomized controlled trials studies were included in this analysis. These studies included a total of 1411 patients: 744 treated with RFA and 667 treated with HR. The overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years (OR: 0.56, 95% CI: 0.44-0.71), and at 5 year (OR: 0.60, 95% CI: 0.36-1.01). RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27). In the HR group the 1, 3, and 5 years disease -free survival rates were significantly better than in the HR-treated patients (respectively: OR: 0.54, 95% CI: 0.35-0.84; OR: 0.44, 95% CI: 0.28-0.68; OR: 0.64, 95% CI: 0.42-0.99). The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality. For tumors <or= 3 cm HR did not differ significantly from RFA for survival, as reported in three NRCTs .<bold>Conclusions: </bold>HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm. However, the findings have to be carefully interpreted due to the lower level of evidence.
- Publication
BMC Gastroenterology, 2010, Vol 10, p78
- ISSN
1471-230X
- Publication type
journal article
- DOI
10.1186/1471-230X-10-78