Percutaneous Radiofrequency Ablation versus Surgical Resection for the Treatment of Small Hepatic Carcinoma: A Meta-analysis

摘要

Aims: To evaluate the curative effect of percutaneous radiofrequency ablation (PRFA) versus surgical resection (SR) for the treatment of small hepatic carcinoma. Methods: Cochrane Library, Medline, Pubmed, CNKI, WanFang, VIP databases were searched from January 1990 to March 2013, then clinical control studies comparing curative effects of PRFA with SR in treatment of small hepatic carcinoma were acquired and reviewed. Qualities of these studies were evaluated. Publication bias was also assessed by using a funnel plot. Then primary outcomes, namely overall survival rates, disease-free survival rates and postoperative complication, were abstracted to conduct a combined analysis by using fixed or random effects model. Results: A total of eight studies involving 1287 patients were included in our study. The PRFA group has a lower overall survival rates over the SR group in 1 year (OR, 0.62; 95% confidence interval [CI], 0.43-0.89; P = 0.009), 3 years (OR, 0.44; 95% CI, 0.27-0.72; P=0.001), and 5 years (OR, 0.49; 95% CI, 0.35-0.68; P＜0.0001). The PRFA group has a lower disease-free survival rates over the SR group in 1 year (OR, 0.63; 95% CI, 0.49-0.82; P=0.0006), 3 years (OR, 0.45; 95% CI, 0.30-0.67; P=0.0001), and 5 years (OR, 0.46; 95% CI, 0.33-0.64; P＜0.00001). The postoperative complication of the PRFA group was lower than the SR group (OR, 0.21; 95% CI, 0.08-0.56; P＜0.00001). Conclusion: PRFA had lower overall survival rates after surgery and disease-free survival than SR, but it has a lower incidence of postoperative complications. Then PRFA, acted as an operation with smaller invasion and shorter hospitalization time, would be a good choice for the patients with hepatic carcinoma who is reluctant to be treated by SR.