Shortand longterm effects of radiofrequency ablation versus minimally invasive hepatectomy in treatment of small hepatocellular carcinoma: A Metaanalysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the short- and long-term effects of radiofrequency ablation (RA) versus minimally invasive hepatectomy (MIH) in the treatment of small hepatocellular carcinoma (SHCC). MethodsPubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, Wanfang Data, and VIP were searched for Chinese and English articles on RA versus MIH in the treatment of sHCC published up to August 2019. Quality assessment was performed for the articles included, and RevMan 5.1 was used for analysis. ResultsA total of 7 studies with 737 patients were included after screening, and there were 393 patients in RA group and 344 patients in MIH group. Compared with the MIH group, the RA group had significantly shorter time of operation (mean difference ［MD］=-206.57, 95% confidence interval ［CI］ -387.28 to -25.86, P=0.03) and length of hospital stay (MD=-4.02, 95%CI -4.94 to -3.10, P＜001), as well as a significantly lower overall incidence rate of postoperative complications (odds ratio ［OR］=0.31, 95%CI 0.20-047, P＜0.01). Compared with the RA group, the MIH group had significantly higher 3-year overall survival rate (OR=0.55, 95%CI 0.36-0.84, P＜0.01), 1-year disease-free survival rate (OR=0.63, 95%CI 0.41-0.98, P=0.04), and 3-year disease-free survival rate (OR=0.51, 95%CI 0.34-0.74, P＜0.01), as well as a significantly lower local recurrence rate after surgery (OR=187, 95%CI 1.31-2.68, P＜0.01). ConclusionIn the treatment of sHCC, RA has good short-term effect, good safety, and poor long-term effect, while MIH has good long-term effect and poor short-term effect.