Affiliation:
1. Department of General Surgery, Yan’An Hospital Affiliated to Kunming Medical University, The Key Laboratory of Tumour Immunological Prevention and Treatment of Yunnan Province, Kunming, China
2. Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
Abstract
Abstract
Background
The efficacy of repeat hepatic resection (rHR) in the treatment of recurrent hepatocellular carcinoma compared with radiofrequency or microwave ablation after resection of the primary tumour remains controversial. A systematic review and meta-analysis were performed to compare the safety and efficacy of these procedures.
Methods
PubMed, Embase, Scopus, Cochrane Library, and China National Knowledge Infrastructure databases were systematically searched to identify related studies published before 10 October 2021. Overall and recurrence-free survival after different treatments were compared based on pooled hazard ratios with a random-effects model.
Results
Two randomized clinical trials and 28 observational studies were included, involving 1961 and 2787 patients who underwent rHR and ablation respectively. Median perioperative mortality in both groups was zero but patients in the rHR group had higher median morbidity rates (17.0 per cent) than those in the ablation group (3.3 per cent). rHR achieved significantly longer recurrence-free survival than ablation (HR 0.79, 95 per cent c.i. 0.70 to 0.89, P < 0.001), while both groups had similar overall survival (HR 0.93, 95 per cent c.i. 0.83 to 1.04, P = 0.18).
Conclusion
rHR and ablation based on radio- or microwaves are associated with similar overall survival in patients with recurrent hepatocellular carcinoma after resection of the primary tumour.
Funder
Guangxi BaGui Scholars
Guangxi Natural Science Foundation
Yunnan Provincial Science and Technology Department
Kunming Medical University
Publisher
Oxford University Press (OUP)
Cited by
7 articles.
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