Radiofrequency ablation vs. surgical resection on the treatment of patients with small hepatocellular carcinoma: a system review and meta-analysis of five randomized controlled trials

Hepatogastroenterology. 2014 Sep;61(134):1722-9.

Abstract

Background/aims: To investigate the meta-analysis of randomized controlled trials(RCTs) of the efficacy and safety between radiofrequency ablation (RFA ) and surgical resection (SR) in treating small hepatocellular carcinoma (SHCC).

Methodology: RCTs comparing RFA with SR for SHCC were collected from PubMed/Medline, Cochrane Library, EMBASE and CNKI data base. Odds ratios and 95% confidence intervals were calculated.

Results: Five RCTs with a total of 776 patients were included in this analysis. The 1-, 3-year overall survival rate and 1-year recurrence-free survival rate were of no difference between the RFA and SR . However, SR was shown to be superior to the RFA with the analysis of 5-year overall rate and 3-, 5-year recurrence-free survival rate. The 1-year recurrence rate was similar between the SR and RFA . However, the 2-, 3-year recurrence rate of RFA is significantly higher than SR . In addition, the SR presented a high complication rate.

Conclusions: SR treatment led to a higher long-term survival rate and a lower long-term recurrence rate, while RFA led to a lower complication rate than SR. However, Further research was needed to investigate the efficacy of RFA because of the inadequate research data and the heterogeneity among the included studies.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Chi-Square Distribution
  • Disease-Free Survival
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Neoplasm Recurrence, Local
  • Odds Ratio
  • Postoperative Complications / etiology
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Burden