Limits...
Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma.

Zhou Y, Zhao Y, Li B, Xu D, Yin Z, Xie F, Yang J - BMC Gastroenterol (2010)

Bottom Line: The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality.For tumors <or= 3 cm HR did not differ significantly from RFA for survival, as reported in three NRCTs .HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First affiliated Hospital of Xiamen University, Xiamen, China.

ABSTRACT

Background: There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)] for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence.

Methods: Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from 1997 to 2009 in PubMed and Medline. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.

Results: One randomized controlled trial, and 9 nonrandomized controlled trials studies were included in this analysis. These studies included a total of 1411 patients: 744 treated with RFA and 667 treated with HR. The overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years (OR: 0.56, 95% CI: 0.44-0.71), and at 5 year (OR: 0.60, 95% CI: 0.36-1.01). RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27). In the HR group the 1, 3, and 5 years disease -free survival rates were significantly better than in the HR-treated patients (respectively: OR: 0.54, 95% CI: 0.35-0.84; OR: 0.44, 95% CI: 0.28-0.68; OR: 0.64, 95% CI: 0.42-0.99). The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality. For tumors

Conclusions: HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm. However, the findings have to be carefully interpreted due to the lower level of evidence.

Show MeSH

Related in: MedlinePlus

Results of the meta-analysis on overall survival at 3 years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2914087&req=5

Figure 1: Results of the meta-analysis on overall survival at 3 years.

Mentions: There was no significant difference in overall survival between the two groups at 1 year (all trials reported this data, OR: 0.84, 95% CI: 0.58-1.21), and at 2 years (four trials reported this data, OR: 0.80, 95% CI: 0.50-1.27), whereas the difference was significant and favourable to HR group at 3 years (nine trials reported this data, OR: 0.56, 95% CI: 0.44-0.71) ( Figure 1), and at 5 year (five trials reported this data, OR: 0.60, 95% CI: 0.36-1.01) (Table 2).


Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma.

Zhou Y, Zhao Y, Li B, Xu D, Yin Z, Xie F, Yang J - BMC Gastroenterol (2010)

Results of the meta-analysis on overall survival at 3 years.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2914087&req=5

Figure 1: Results of the meta-analysis on overall survival at 3 years.
Mentions: There was no significant difference in overall survival between the two groups at 1 year (all trials reported this data, OR: 0.84, 95% CI: 0.58-1.21), and at 2 years (four trials reported this data, OR: 0.80, 95% CI: 0.50-1.27), whereas the difference was significant and favourable to HR group at 3 years (nine trials reported this data, OR: 0.56, 95% CI: 0.44-0.71) ( Figure 1), and at 5 year (five trials reported this data, OR: 0.60, 95% CI: 0.36-1.01) (Table 2).

Bottom Line: The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality.For tumors <or= 3 cm HR did not differ significantly from RFA for survival, as reported in three NRCTs .HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First affiliated Hospital of Xiamen University, Xiamen, China.

ABSTRACT

Background: There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)] for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence.

Methods: Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from 1997 to 2009 in PubMed and Medline. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.

Results: One randomized controlled trial, and 9 nonrandomized controlled trials studies were included in this analysis. These studies included a total of 1411 patients: 744 treated with RFA and 667 treated with HR. The overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years (OR: 0.56, 95% CI: 0.44-0.71), and at 5 year (OR: 0.60, 95% CI: 0.36-1.01). RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27). In the HR group the 1, 3, and 5 years disease -free survival rates were significantly better than in the HR-treated patients (respectively: OR: 0.54, 95% CI: 0.35-0.84; OR: 0.44, 95% CI: 0.28-0.68; OR: 0.64, 95% CI: 0.42-0.99). The postoperative morbidity was higher with HR (OR: 0.29, 95% CI: 0.13-0.65), but no significant differences were found concerning mortality. For tumors

Conclusions: HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments, particularly for tumors > 3 cm. However, the findings have to be carefully interpreted due to the lower level of evidence.

Show MeSH
Related in: MedlinePlus