Liver resection had better disease-free survival rates compared with radiofrequency ablation in hepatocellular carcinoma: A meta-analysis based on randomized clinical trials-Reference-Cited by-同舟云学术

Liver resection had better disease-free survival rates compared with radiofrequency ablation in hepatocellular carcinoma: A meta-analysis based on randomized clinical trials

Published:2024-07-17 Issue: Volume: Page:
ISSN:1743-9159
Container-title:International Journal of Surgery
language:en
Short-container-title:

Author:

Yeo Yee-Hui¹,Kang Yi-No²³,Chen Chiehfeng²³⁴⁵,Lee Teng-Yu⁶⁷,Yeh Chun-Chieh⁸⁹,Huang Tsai-Wei²¹⁰¹¹¹²,Wu Chun-Ying¹³¹⁴¹⁵¹⁶¹⁷

Affiliation:

1. Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

2. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

3. Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taiwan

4. Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan

5. Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital, Taipei, Taiwan

6. Division of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan

7. Department of Medicine, Chung Shan Medical University, Taichung, Taiwan

8. School of Medicine, China Medical University Hospital, Taichung, Taiwan

9. Department of Surgery, China Medical University, Taichung, Taiwan

10. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

11. Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei, Taiwan

12. Department of Nursing, Wan Fang Hospital, Taipei, Taiwan

13. Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan

14. Health Innovation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

15. Microbiota Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

16. Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan

17. Department of Public Health, China Medical University, Taichung, Taiwan

Abstract

Background: 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. We conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA. Methods: We 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). We used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable. Results: Our meta-analysis included nine RCTs with a total of 1,516 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. Discussion: 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.

Publisher

Ovid Technologies (Wolters Kluwer Health)