Chen Ru-Fu, Xiao Tiao-Hua, Zhou Quan-Bo
Department of Hepatobiliary Surgery, the Second Affiliated Hospital of SUN Yat-sen University, Guangzhou 510120, China.
Zhonghua Wai Ke Za Zhi. 2008 Sep 15;46(18):1413-8.
To evaluate the value of radiofrequency ablation in the treatment of small hepatocellular carcinoma (HCC).
MEDLINE (1966 - 2008), EMBASE (1966 - 2008), CBMdisc (1978 - 2008) were searched. The Cochrane Library, Evidence Base Medicine Reviews (Ovid Edition), Cancerlit (1993 - 2008) and so on, date of last search: 30 January 2008. There were no restrictions in language. Randomized controlled trials (RCTs) and non-RCTs were both included in this study, and the quality of each included study was assessed. Meta-analysis was performed by RevMan 4.2 software.
Four prospective controlled studies and two retrospective studies met the inclusion criteria. The results of meta-analysis showed that 1-, 3-, 4-year survival rates and 1-year tumor-free survival rate had not statistically significant difference in RFA group compared with surgical resection group (P > 0.05), but surgical resection was more effective to improve 3-year tumor-free survival rate than RFA (P < 0.05).
The effect of RFA therapy on small HCC is similar to resection, RFA could be considered as the first-line treatment of choice for surgical candidates with small HCC in cirrhotic patients.
评估射频消融术治疗小肝细胞癌(HCC)的价值。
检索MEDLINE(1966 - 2008年)、EMBASE(1966 - 2008年)、CBMdisc(1978 - 2008年)。检索Cochrane图书馆、循证医学评价(Ovid版)、Cancerlit(1993 - 2008年)等,最后检索日期为2008年1月30日。语言无限制。本研究纳入随机对照试验(RCT)和非RCT,评估每项纳入研究的质量。采用RevMan 4.2软件进行荟萃分析。
四项前瞻性对照研究和两项回顾性研究符合纳入标准。荟萃分析结果显示,与手术切除组相比,射频消融组1年、3年、4年生存率及1年无瘤生存率差异无统计学意义(P>0.05),但手术切除在提高3年无瘤生存率方面比射频消融更有效(P<0.05)。
射频消融术治疗小肝癌的效果与手术切除相似,对于肝硬化合并小肝癌且适合手术的患者,射频消融术可作为一线治疗选择。