Radio-frequency ablation versus hepatic surgery for the treatment of hepatocellular carcinoma: a systematic review and meta-analysis

Abstract

Background Hepatocellular carcinoma (HCC) is the most common malignant tumor composed of cells resembling hepatocytes. It is the fourth most common cause of cancer‐related death on earth. Treatment involves radio frequency ablation (RFA )or hepatic resection (HR) . This is a review & evaluation of evidence comparing either methods by using meta-analysis technique. Materials and methods We conducted a database search of the PUBMED, GOOGLE SCHOLAR, Cochrane, EMBASE etc. in which total of 36 observational studies and 3 RCTs following PRISMA guidelines till September 2020 and matching inclusion and exclusion criteria were collected. These studies include total 16,700 patients out of which 8565 were treated with RFA & 8135 with surgery. The following search strings were used: "RFA vs HR", "hepatocellular carcinoma treatment". The primary end point was overall survival rate in 3&5 years respectively, including hospital stay duration & local recurrence. RevMan 5.3 was used for appropriate statistical tests. Fixed and Random Effect Model Tests was used and p<0.05 was considered statistically significant. Results Meta-analysis showed that RFA was associated with significant decrease in the length of hospital stay for RCTs (SMD = -2.171 , CI = -2.381 to - 1.962 , p=<0.001) and non-RCTs ( SMD = -1.048 , CI = 1.492 to -0.937, p=<0.001) respectively. However, it was also associated with significant increase incidence of recurrence (RR = 1.749, 95% CI = 1.444 to 2.119, p=<0.001) and significantly poorer 3-year (RR = 0.850, 95% CI = 0.772 to 0.935, p=0.001); (RR = 0.941, 95%CI = 0.927 to 0.956, p=<0.001) survival chances for RCTs and non-RCTs respectively. 5-year survivability was (RR=0.856, 95% CI = 0.835 to 0.878, p=0.001). Conclusion: Although RFA was associated with decreased duration of hospital stay, it was associated with increased chances of recurrence compared to hepatic resection. 3-year survival rate was also poorer. 

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The reference section of the meta-analysis manuscript contains all the relevant links from where the data was collected and used in the analysis.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present work are contained in the manuscript

留言 (0)

沒有登入
gif