中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 2
Feb.  2020
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Article Contents

Short-and long-term effects of radiofrequency ablation versus minimally invasive hepatectomy in treatment of small hepatocellular carcinoma: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2020.02.025
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  • Received Date: 2019-09-05
  • Published Date: 2020-02-20
  • 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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  • [1] DENG GL,ZENG S,SHEN H. Chemotherapy and target therapy for hepatocellular carcinoma:New advances and challenges[J]. World J Hepatol,2015,7(5):787-798.
    [2] XU G,MA J,JIA W,et al. The clinical value of contrast-enhanced ultrasonography in diagnosing primary hepatocellular carcinoma[J]. J Hepatobiliary Surg,2011,4(29):261-264.
    [3] MAZZAFERRO V,REGALIA E,DOCI R,et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis[J]. N Engl J Med,1996,334(11):693-699.
    [4] BRUIX J,SHEMAN M. Management of hepatocellular carcinoma:An update[J]. Hepatology,2011,53(3):1020-1022.
    [5] SONG JX,CHEN J,LI JW,et al. Clinical analysis of laparoscopic hepatectomy and radiofrequency ablation in the treatment of early hepatocellular carcinoma[J]. J Hepatobiliary Surg,2017,25(5):349-353.(in Chinese)宋举贤,陈健,李建伟,等.腹腔镜肝切除术与射频消融术治疗早期肝癌的临床分析[J].肝胆外科杂志,2017,25(5):349-353.
    [6] XU ZJ,XU GL,MA JL,et al. Ultrasound guided percutaneous radiofrequency ablation versus laparoscopic hepatectomy for small primary liver cancer[J]. Chin J Gen Surg,2017,26(1):18-24.(in Chinese)徐治军,许戈良,马金良,等.超声引导下经皮射频消融与腹腔镜肝切除术治疗原发性小肝癌的对比研究[J].中国普通外科杂志,2017,26(1):18-24.
    [7] QIU J,CHEN S,CHENG YD. A systematic review of roboticassisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms[J]. Surg Endosc,2016,30(3):862-875.
    [8] BUCHS NC,OLDANI G,ORCI LA,et al. Current status of robotic liver resection:A systematic review[J]. Expert Rev Anticancer Ther,2014,14(2):237-246.
    [9] YIN Z,FAN X,YE H,et al. Short-and long-term outcomes after laparoscopic and open hepatectomy for hepatocellular carcinoma:A global systematic review and meta-analysis[J]. Ann Surg Oncol,2013,20(4):1203-1215.
    [10] HIROKAWA F,HAYASHI M,MIYAMOTO Y,et al. Short-and long-term outcomes of laparoscopic versus open hepatectomy for small malignant liver tumors:A single-center experience[J]. Surg Endosc,2015,29(2):458-465.
    [11] MINAMI Y,KUDO M. Radiofrequency ablation of hepatocellular carcinoma:Current status[J]. World J Radiol,2010,2(11):417-424.
    [12] HOU XW,SHI JP,CHEN X. How to estimate the mean and standard deviation based on the median,range and sample size when conducting meta-analysis[J]. Chin J Evid Based Med,2015,15:484-487.
    [13] HOZO SP,DJUBEGOVIC B,HOZO I. Estimating the mean and variance from the median,range and the size of a simple[J]. BMC Med Res Methodol,2005,5:13.
    [14] SEIRERT H,WEHRMANN T,SCHMITT T,et al. Retroperitoneal endoscopic debridement for infected peripanereatic necrosis[J]. Lancet,2000,356(9230):653-655.
    [15] STANG A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol,2010,25(9):603-605.
    [16] HIGGINS JP,GREEN S. Cochrane handbook for systematic reviews of interventions[M]. John Wiley&Sons,Hoboken,2011:1.
    [17] CASACCIA M,SANTORI G,BOTTINO G,et al. Laparoscopic resection vs laparoscopic radiofrequency ablation for the treatment of small hepatocellular carcinomas:A singlecenter analysis[J]. World J Gastroenterol,2017,23(4):653-660.
    [18] CASACCIA M,SANTORI G,BOTTINO G,et al. The procedure outcome of laparoscopic resection for‘small’hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation[J]. J Minim Access Surg,2015,11(4):231-235.
    [19] SONG J,WANG Y,MA K,et al. Laparoscopic hepatectomy versus radiofrequency ablation for Minimally invasive treatment of single,small hepatocellular carcinomas[J]. Surg Endosc,2015,30(10):4249-4257.
    [20] VITALI GC,LAURENT A,TERRAZ S,et al. Minimally invasive surgery versus percutaneous radio frequency ablation for the treatment of single small(
    [21] ZHANG HY,ZHUANG ZB,LIN CD,et al. Efficacy and prognosis comparison of percutaneous radiofrequency ablation and laparoscopic hepatectomy in treatment of small hepatocellular carcinoma[J]. Chin J Gen Surg,2019,28(1):24-30.(in Chinese)张汉洋,庄志彬,林春冬,等.经皮射频消融术与腹腔镜肝切除术治疗原发性小肝癌的疗效及预后比较[J].中国普通外科杂志,2019,28(1):24-30.
    [22] WNG Y,LUO Q,LI Y,et al. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinomas:A meta-analysis of randomized and nonrandomized controlled trials[J]. PLo S One,2014,9(1):e84484.
    [23] XING AL,ZHENG JS. Clinical effect of transcatheter arterial chemoization combined with local thermal ablation in treatment of large hepatocellular carcinoma and related influencing factors[J]. J Clin Hepatol,2019,35(1):98-103.(in Chinese)邢爱丽,郑加生.经肝动脉化疗栓塞术联合局部热消融治疗大肝癌的效果及影响因素[J].临床肝胆病杂志,2019,35(1):98-103.
    [24] FAN XK,SHI LJ,GUO L,et al. Comparison of laparoscopicguided radiofrequency ablation and laparoscopic hepatectomy for the treatment of hepatocellular carcinoma[J]. J Clin Exp Med,2018,17(14):1540-1544.(in Chinese)范学科,史良俊,郭林.经腹腔镜引导射频消融术与腹腔镜肝切除术治疗肝细胞癌的近远期疗效对比分析[J].临床和实验医学杂志,2018,17(14):1540-1544.
    [25] RHIM H,LIM HK. Radiofrequency ablation of hepatocellular carcinoma:Pros and cons[J]. Gut Liver,2018,4(Suppl 1):s113-s118.
    [26] XU Q,KOBAYASHI S,YE X,et al. Comparison of hepaticresection and radiofrequency ablation for small hepatocellular carcinoma:A meta-analysis of 16,103 patients[J]. Sci Rep,2014,4(28):7252.
    [27] ZHOUU Y,ZHAO Y,LI B,et al. Metaanalysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma[J]. BMC Gastroenterol,2010,10(3):78.
    [28] MA Y,ZHANG P,WANG F,et al. Association between vitamin D and risk of colorectal cancer:A systematic review of prospective studies[J]. J Clin Oncol,2011,29(28):3775-3782.
    [29] ZOU H,WU LQ. A propensity score matching analysis of hepatectomy and radiofrequency ablation for patients with solitary hepatocellular carcinoma less than or equal to 5 cm and portal hypertension[J]. Chin J Dig Surg,2018,17(10):1018-1023.(in Chinese)邹浩,吴力群.肝切除术与射频消融术治疗单发肿瘤直径≤5 cm肝细胞癌合并门静脉高压症患者的倾向评分匹配疗效分析[J].中华消化外科杂志,2018,17(10):1018-1023.
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