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首页> 外文期刊>Surgical Endoscopy >Efficacy and safety of radiofrequency ablation versus minimally invasive liver surgery for small hepatocellular carcinoma: a systematic review and meta-analysis
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Efficacy and safety of radiofrequency ablation versus minimally invasive liver surgery for small hepatocellular carcinoma: a systematic review and meta-analysis

机译：射频消融的功效和安全性与小型肝细胞癌的微创肝脏手术：系统评价和荟萃分析

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BackgroundThe aim of this study was to compare radiofrequency ablation (RFA) with minimally invasive liver surgery (MIS) in the treatment of small hepatocellular carcinoma (SHCC) and to assess short-term and long-term clinical outcomes.MethodsPubMed, Embase, Cochrane Library, Web of science, and CBM were systematically searched for articles from inception to July 2018, comparing RFA and MIS in SHCC treatment. We evaluated overall survival (OS), disease-free survival (DFS), local recurrence, and complication rates, as well as hospitalization duration and operation times.ResultsSix retrospective studies were analyzed, including a total of 597 patients, 313 treated with RFA and 284 treated with MIS. OS rates were significantly higher in patients treated with MIS at 3years, when compared to RFA (OR 0.55; 95% CI 0.36 to 0.84). The 3-year DFS MIS rates were also superior to RFA (OR 0.63; 95% CI 0.41 to 0.98). In contrast, when compared to MIS, RFA demonstrated a significantly higher rate of local intrahepatic recurrences, (OR 2.24; 95% CI 1.47 to 3.42), and a lower incidence of postoperative complications (OR 0.34; 95% CI 0.22 to 0.53), as well as shorter operation times (OR -145.31, 95% CI -200.24 to -90.38) and hospitalization duration (OR -4.02,95% CI -4.94 to -3.10).ConclusionsWe found that MIS led to higher OS, DFS, and lower local recurrences in SHCC patients. Meanwhile, RFA treatments led to significantly lower complication rates, shorter operation times, and hospitalization duration. Considering long-term outcomes, MIS was found to be superior to RFA. However, RFA may be an alternative treatment for patients presenting a single SHCC nodule (<= 3cm), given its minimally invasive nature and its comparable long-term efficacy with MIS. Nevertheless, our findings should be explained with caution due to the low level of evidence obtained.
机译：本研究的背景：目的是微创肝脏手术（MIS）以小肝细胞癌（SHCC）的治疗中比较射频消融（RFA），并评估短期和长期的临床outcomes.MethodsPubMed，文摘，Cochrane图书馆，网络科学和煤层气进行了系统搜索从成立文章2018年7月，在小肝癌的治疗比较RFA和MIS。我们评估总生存期（OS），无病生存（DFS），局部复发和并发症发生率，以及住院时间和操作times.ResultsSix回顾性研究进行分析，共包括597例，313 RFA治疗和284与MIS处理。相比RFA时与MIS在3年，治疗的患者OS率显著较高（OR 0.55; 95％CI 0.36至0.84）。 3年DFS MIS率也优于RFA（OR 0.63; 95％CI 0.41至0.98）。相反，相比MIS时，RFA表现出显著较高速率本地肝内复发，（OR 2.24; 95％CI 1.47至3.42），和术后并发症的发生率较低（OR 0.34; 95％CI 0.22至0.53），以及较短的操作时间（OR -145.31，95％CI -200.24至-90.38）和住院时间（OR -4.02,95％CI -4.94至-3.10）.ConclusionsWe发现MIS导致了更高的OS，DFS，和降低小肝癌患者的局部复发。同时，RFA治疗导致显著降低并发症发生率，缩短手术时间和住院时间。考虑到长期的结果，MIS被认为是优于RFA。然而，RFA可以是用于患者呈现单个小肝癌结节（<=3厘米）的替代治疗，由于其微创性质并用MIS其可比长期疗效。然而，我们的研究结果应谨慎，由于所获得的证据低水平解释。

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