A meta-analysis of long-term survival outcomes between surgical resection and radiofrequency ablation in patients with single hepatocellular carcinoma ≤ 2 cm (BCLC very early stage)

Int J Surg. 2018 Aug:56:61-67. doi: 10.1016/j.ijsu.2018.04.048. Epub 2018 Apr 30.

Abstract

Introduction: The optimal management choice in consideration of long-term overall survival (OS) and disease-free survival (DFS) for patients with BLCL very early stage is a matter of debate.

Aim: A systematic review and meta-analysis was conducted to evaluate the efficacy of liver resection (RES) and radiofrequency ablation (RFA) for single HCC 2 cm or less.

Material and method: The primary sources of the reviewed studies through December 2017, without restriction on the languages or regions, were Pubmed and Embase. The hazard ratio (HR) was used as a summary statistic for long-term outcomes.

Results: A total of 5 studies qualified for inclusion in this quantified meta-analysis with a total of 729 HCC patients of BCLC very early stage. Only postoperative 1-year OS was comparable in both RES and RFA groups. As for long-term outcomes of 3-year and 5-year OSs, RES was significantly better than RFA, the HRs were 0.64 (95%CI: 0.41, 1.00; P = 0.05) and 0.63 (95%CI: 0.42, 0.95; P = 0.03) respectively. In terms of postoperative DFS, reduced tumor recurrence was observed in RES, and all the short- and long-terms outcomes were favored RES.

Discussion: RES offers better long-term oncologic outcomes compared with RFA in current clinical evidences.

Keywords: BLCL very early stage; Hepatocellular carcinoma; Liver resection (RES); Radiofrequency ablation (RFA).

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods*
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Liver / pathology
  • Liver / surgery
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Neoplasm Recurrence, Local / surgery
  • Proportional Hazards Models
  • Survival Rate
  • Treatment Outcome