Short-and long-term effects of radiofrequency ablation versus minimally invasive hepatectomy in treatment of small hepatocellular carcinoma: A Meta-analysis
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摘要:
目的比较射频消融术(RA)和微创切除术(MIH)治疗小肝细胞癌(SHCC)的短期和长期效果。方法系统检索PubMed、Web of Science、Embase、Cochrane Library、中国生物医学文献数据库、中国知网数据库、万方数据库和维普数库比较RA与MIH治疗SHCC效果的所有中英文文献,检索时间截至2019年8月。对纳入文献进行质量学评价后,采用Revman 5. 1软件进行分析。结果经筛选后共纳入7篇研究,包括737例患者,其中RA组393例,MIH组344例。与MIH组相比,RA组的手术时间[均值(MD)=-206. 57,95%可信区间(95%CI):-387. 28~-25. 86,P=0. 03]、住院时间(MD=-4. 02,95%CI:-4. 94~-3. 10,P <0. 01)较短,而且术后总体并发症发生率[比值比(OR)=0. 31,95%CI:0. 20~0. 47,P <0. 01]更低。MIH组术后3年总体生存率(OR=0. 55,95%CI:0. 36~0. 84,P <0. 01)、术后1年(OR=0. 63,95%CI...
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关键词:
- 癌,肝细胞 /
- 消融技术 /
- 最小侵入性外科手术 /
- 治疗结果 /
- Meta分析(主题)
Abstract:Objective To investigate the short-and long-term effects of radiofrequency ablation( RA) versus minimally invasive hepatectomy( MIH) in the treatment of small hepatocellular carcinoma( SHCC). Methods PubMed,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 s HCC published up to August 2019. Quality assessment was performed for the articles included,and RevMan 5. 1 was used for analysis. Results A 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). Conclusion In the treatment of s HCC,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.
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