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01.12.2012 | Review | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Meta-analysis of surgical resection and radiofrequency ablation for early hepatocellular carcinoma

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
Gang Xu, Fu-zhen Qi, Jian-huai Zhang, Guo-feng Cheng, Yong Cai, Yi Miao
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-163) contains supplementary material, which is available to authorized users.
Gang Xu, Fu-zhen Qi contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

XG, QFZ, and MY designed the studyand wrote the manuscript.XG, QFZ, ZJH, CGF, and CY performed data acquisition.MY performed quality control of data.XG, QFZ, and MY performed statistical analysis and interpretation. All authors read and approved the final manuscript. XG and QFZ contributed equally to this work.

Abstract

Background

There is no definite agreement on the better therapy (radiofrequency ablation (RFA) versus surgical resection (SR)) for early hepatocellular carcinoma (HCC) eligible for surgical treatments. The purpose of this study is to evaluate the evidence using meta-analytical techniques.

Methods

A literature search was undertaken until December 2011 to identify comparative studies evaluating survival rates, recurrence rates, and complications. Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated with either the fixed or random effect model.

Results

Thirteen articles, comprising two randomized controlled trials(RCTs), were included in the review, with a total of 2,535 patients (1,233 treated with SR and 1,302 with RFA). The overall survival rates were significantly higher in patients treated with SR than RFA after1, 3, and 5 years (respectively: OR, 0.60 (95% CI, 0.42 to 0.86); OR, 0.49 (95% CI, 0.36 to 0.65); OR, 0.60 (95% CI, 0.43 to 0.84)). In the SR group, the 1, 3, and 5 years recurrence rates were significantly lower than the RFA group (respectively: OR, 1.48 (95% CI, 1.05 to 2.08); OR, 1.76 (95% CI, 1.49 to 2.08); OR, 1.68 (95% CI, 1.21 to 2.34)). However, local recurrence between two groups did not exhibit significant difference. For HCC ≤ 3 cm in diameter, SR was better than RFA at the 1, 3, and 5 years overall survival rates (respectively: OR, 0.34 (95% CI, 0.13 to 0.89); OR, 0.56 (95% CI, 0.37 to 0.84); OR, 0.44 (95% CI, 0.31 to 0.62)). This meta-analysis indicated that the complication of SR was higher than RFA (OR, 6.25 (95%CI, 3.12 to 12.52); P = 0.000).

Conclusion

Although local recurrence between two groups did not exhibit significant difference, SR demonstrated significantly improved survival benefits and lower complications for patients with early HCC, especially for HCC ≤ 3 cm in diameter. These findings should be interpreted carefully, owing to the lower level of evidence.
Zusatzmaterial
Authors’ original file for figure 1
12957_2012_1081_MOESM1_ESM.ppt
Authors’ original file for figure 2
12957_2012_1081_MOESM2_ESM.ppt
Authors’ original file for figure 3
12957_2012_1081_MOESM3_ESM.ppt
Authors’ original file for figure 4
12957_2012_1081_MOESM4_ESM.ppt
Literatur
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