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Liver resection had better disease-free survival rates compared with radiofrequency ablation in hepatocellular carcinoma: a meta-analysis based on randomized clinical trials
Journal
International Journal of Surgery
Journal Volume
110
Journal Issue
11
Start Page
7225-7233
ISSN
1743-9159
Date Issued
2024-07-17
Author(s)
Yee-Hui Yeo
Yi-No Kang
Chiehfeng Chen
Teng-Yu Lee
Chun-Chieh Yeh
Tsai-Wei Huang
Chun-Ying Wu
Abstract
<jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Liver resection (LR) and radiofrequency ablation (RFA) are the most commonly used treatment modalities for early-stage hepatocellular carcinoma (ES-HCC). The comparative efficacy of LR and RFA in ES-HCC remains debated. The authors conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>The authors searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing RFA and LR interventions for the treatment of ES-HCC. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The authors used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>Our meta-analysis included nine RCTs with a total of 1516 HCC patients. Compared with patients receiving RFA, those receiving LR did not have significantly different 2-year OS (HR=1.28, 95% CI: 0.73–2.23) and 5-year OS (HR=1.49, 95% CI: 0.99–2.24). However, patients receiving LR showed a favorable trend in 2-year DFS (HR=1.40, 95% CI: 1.16–1.69) and 5-year DFS (HR=1.37; 95% CI: 1.05–1.77), although these results are not conclusive due to underpowered significance. The heterogeneity was low, and the outcomes were statistically reliable.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Discussion:</jats:title>
<jats:p>Meta-analysis suggests that while LR shows a favorable trend in DFS compared to RFA for ES-HCC, the present evidence does not thoroughly support recommending LR over RFA. The inconclusive nature of these findings highlights the need for further large-scale RCTs to establish definitive comparative efficacy.</jats:p>
</jats:sec>
<jats:title>Background:</jats:title>
<jats:p>Liver resection (LR) and radiofrequency ablation (RFA) are the most commonly used treatment modalities for early-stage hepatocellular carcinoma (ES-HCC). The comparative efficacy of LR and RFA in ES-HCC remains debated. The authors conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>The authors searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing RFA and LR interventions for the treatment of ES-HCC. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The authors used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>Our meta-analysis included nine RCTs with a total of 1516 HCC patients. Compared with patients receiving RFA, those receiving LR did not have significantly different 2-year OS (HR=1.28, 95% CI: 0.73–2.23) and 5-year OS (HR=1.49, 95% CI: 0.99–2.24). However, patients receiving LR showed a favorable trend in 2-year DFS (HR=1.40, 95% CI: 1.16–1.69) and 5-year DFS (HR=1.37; 95% CI: 1.05–1.77), although these results are not conclusive due to underpowered significance. The heterogeneity was low, and the outcomes were statistically reliable.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Discussion:</jats:title>
<jats:p>Meta-analysis suggests that while LR shows a favorable trend in DFS compared to RFA for ES-HCC, the present evidence does not thoroughly support recommending LR over RFA. The inconclusive nature of these findings highlights the need for further large-scale RCTs to establish definitive comparative efficacy.</jats:p>
</jats:sec>
Publisher
Ovid Technologies (Wolters Kluwer Health)
Type
journal-article