Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China.
World J Gastroenterol. 2011 Sep 28;17(36):4143-8. doi: 10.3748/wjg.v17.i36.4143.
To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection (HR) for solitary colorectal liver metastases (CLM).
A literature search was performed to identify comparative studies reporting outcomes for both RFA and HR for solitary CLM. Pooled odds ratios (OR) with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.
Seven nonrandomized controlled trials studies were included in this analysis. These studies included a total of 847 patients: 273 treated with RFA and 574 treated with HR. The 5 years overall survival rates in the HR group were significantly better than those in the RFA group (OR: 0.41, 95% CI: 0.22-0.90, P = 0.008). RFA had a higher rate of local intrahepatic recurrence compared to HR (OR: 4.89, 95% CI: 1.73-13.87, P = 0.003). No differences were found between the two groups with respect to postoperative morbidity and mortality.
HR was superior to RFA in the treatment of patients with solitary CLM. However, the findings have to be carefully interpreted due to the lower level of evidence.
评估射频消融（RFA）与肝切除术（HR）治疗单发结直肠肝转移瘤（CLM）的疗效比较。
对同时报告 RFA 和 HR 治疗单发 CLM 结局的研究进行文献检索。采用固定效应模型或随机效应模型计算合并优势比（OR）及其 95%置信区间（95%CI）。
本分析纳入了 7 项非随机对照试验研究，共纳入 847 例患者：273 例接受 RFA 治疗，574 例接受 HR 治疗。HR 组的 5 年总生存率显著优于 RFA 组（OR：0.41，95%CI：0.22-0.90，P=0.008）。与 HR 相比，RFA 局部肝内复发率更高（OR：4.89，95%CI：1.73-13.87，P=0.003）。两组术后发病率和死亡率无差异。
HR 治疗单发 CLM 优于 RFA，但由于证据水平较低，结果需谨慎解读。
