Comparison of the safety and efficacy of hepatic resection and radiofrequency ablation in the treatment of single small hepatocellular carcinoma: systematic review and meta-analysis

Ke Wang; Rui Wang; Siqin Liu; Guoqing Peng; Huan Yu; Xiaomei Wang

doi:10.21037/tcr-22-563

Comparison of the safety and efficacy of hepatic resection and radiofrequency ablation in the treatment of single small hepatocellular carcinoma: systematic review and meta-analysis

Transl Cancer Res. 2022 Mar;11(3):580-590. doi: 10.21037/tcr-22-563.

Authors

Ke Wang¹, Rui Wang¹, Siqin Liu², Guoqing Peng¹, Huan Yu¹, Xiaomei Wang¹

Affiliations

¹ Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Department of Neurology, Affiliated Hospital of Zunyi Medical University, Guizhou, China.

Abstract

Background: The present study aimed to compare the safety and efficacy of minimally invasive hepatic resection (HR) and radiofrequency ablation (RFA) in the treatment of single small hepatocellular carcinoma via systematic review and meta-analysis.

Methods: We conducted electronic literature searches of PubMed, Embase, and The Cochrane Library databases, A case-controlled trial comparing HR and RFA in the treatment of single small hepatocellular carcinoma published between 2010 and January 15, 2022 was searched and reported outcomes were overall survival, postoperative complications, intraoperative blood loss, duration of surgery, and recurrence. Literature met inclusion criteria were screened out, and the quality of the methodology used in the included literature was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using RevMan 5.4 software.

Results: Eleven articles were included, including 2,001 patients, including 1,071 in the RFA group and 930 in the HR group. Offset risk assessment results are published offset. Meta-analysis showed that the overall survival rate at 1, 3, and 5 years in RFA group was higher than that in HR group, the difference between the two groups was statistically significant at 1 year [odds ratio (OR) =1.57, 95% confidence interval (CI): 1.14, 2.17, P=0.006], 3 years (OR =1.81, 95% CI: 1.42, 2.30, P<0.00001], and 5 years (OR =1.87, 95% CI: 1.47, 2.37, P<0.00001). The incidence of postoperative complications was significantly lower in the RFA group than in the human resources group [risk ratio (RR) =1.75, 95% CI: 1.02, 3.00, P=0.04], and length of hospital stay [standard mean difference (SMD) =2.92, 95% CI: 0.54, 5.30, P=0.02], operation time (SMD =2.87, 95% CI: 2.57, 3.16, P<0.00001) were shorter than those in HR group. However, the recurrence rate of RFA group was higher than that of HR group (OR =0.49, 95% CI: 0.36, 0.66, P<0.00001).

Conclusions: RFA has the advantage of having more advantages and fewer complications in the treatment of small hepatocellular carcinoma. Minimal complications can occur for patients when achieving satisfactory treatment results. A new treatment option is available for clinicians in the treatment of small liver cancer.

Keywords: Hepatic resection; radiofrequency ablation (RFA); single; small hepatocellular carcinoma (HCC); systematic review.