Sutherland Leanne M, Williams John A R, Padbury Robert T A, Gotley David C, Stokes Bryant, Maddern Guy J
Australian Safety and Efficacy Register of New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, Stepney.
Arch Surg. 2006 Feb;141(2):181-90. doi: 10.1001/archsurg.141.2.181.
To systematically review radiofrequency ablation (RFA) for treating liver tumors.
Databases were searched in July 2003.
Studies comparing RFA with other therapies for hepatocellular carcinoma (HCC) and colorectal liver metastases (CLM) plus selected case series for CLM.
One researcher used standardized data extraction tables developed before the study, and these were checked by a second researcher.
For HCC, 13 comparative studies were included, 4 of which were randomized, controlled trials. For CLM, 13 studies were included, 2 of which were nonrandomized comparative studies and 11 that were case series. There did not seem to be any distinct differences in the complication rates between RFA and any of the other procedures for treatment of HCC. The local recurrence rate at 2 years showed a statistically significant benefit for RFA over percutaneous ethanol injection for treatment of HCC (6% vs 26%, 1 randomized, controlled trial). Local recurrence was reported to be more common after RFA than after laser-induced thermotherapy, and a higher recurrence rate and a shorter time to recurrence were associated with RFA compared with surgical resection (1 nonrandomized study each). For CLM, the postoperative complication rate ranged from 0% to 33% (3 case series). Survival after diagnosis was shorter in the CLM group treated with RFA than in the surgical resection group (1 nonrandomized study). The CLM local recurrence rate after RFA ranged from 4% to 55% (6 case series).
Radiofrequency ablation may be more effective than other treatments in terms of less recurrence of HCC and may be as safe, although the evidence is scant. There was not enough evidence to determine the safety or efficacy of RFA for treatment of CLM.
系统评价射频消融术（RFA）治疗肝肿瘤的效果。
于2003年7月检索数据库。
比较RFA与其他治疗肝细胞癌（HCC）和结直肠癌肝转移（CLM）的疗法的研究，以及CLM的选定病例系列。
一名研究人员使用研究前制定的标准化数据提取表，另一名研究人员进行核对。
对于HCC，纳入了13项比较研究，其中4项为随机对照试验。对于CLM，纳入了13项研究，其中2项为非随机比较研究，11项为病例系列。RFA与治疗HCC的任何其他方法之间的并发症发生率似乎没有明显差异。在一项随机对照试验中，RFA治疗HCC的2年局部复发率比经皮乙醇注射显示出统计学上的显著优势（6%对26%）。据报道，RFA后局部复发比激光诱导热疗后更常见，与手术切除相比，RFA的复发率更高且复发时间更短（各1项非随机研究）。对于CLM，术后并发症发生率为0%至33%（3项病例系列）。RFA治疗的CLM组诊断后的生存期比手术切除组短（1项非随机研究）。RFA后CLM的局部复发率为4%至55%（6项病例系列）。
射频消融术在减少HCC复发方面可能比其他治疗更有效，并且可能同样安全，尽管证据不足。没有足够的证据来确定RFA治疗CLM的安全性或有效性。
