Radiofrequency ablation versus resection for hepatocellular carcinoma in patients with Child-Pugh A liver cirrhosis: a meta-analysis

Clin Radiol. 2017 Dec;72(12):1066-1075. doi: 10.1016/j.crad.2017.07.024. Epub 2017 Aug 26.

Abstract

Aim: To evaluate whether radiofrequency ablation (RFA) or surgical resection (RES) has superior overall survival (OS) and disease-free survival (DFS) in patients with hepatocellular carcinoma and Child-Pugh class A liver cirrhosis.

Materials and methods: Meta-analysis was used to compare 1-, 3-, and 5-year OS and DFS between RFA and RES. Those studies meeting inclusion criteria and published prior to 1 June 2015 were included. The odds ratio (OR) was used as the treatment effect measure. A priori defined sensitivity analyses of study subgroups was performed.

Results: Fifteen studies were included in this analysis. Subgroup analyses based on predetermined patient characteristics were performed to minimise bias. No difference in 1-year OS, 3-year OS, and 3-year DFS was found in analyses limited to studies where patients were equally eligible for both therapies. There was also not a significant difference in OS and DFS between RFA and RES when studies were limited to those with only solitary tumours or tumours <3 cm.

Conclusion: The data suggest the equivalence of RFA and RES in patients with solitary tumours <3 cm and good liver status based on Child-Pugh score.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation* / methods
  • Disease-Free Survival
  • Humans
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / surgery
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Middle Aged
  • Survival Analysis