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: RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27).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 .

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: RFA has a higher rates of local intrahepatic recurrence compared to HR (OR: 4.50, 95% CI: 2.45-8.27).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 .

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