Radiofrequency ablation vs. surgical resection on the treatment of patients with small hepatocellular carcinoma: a system review and meta-analysis of five randomized controlled trials.

BACKGROUND/AIMS: To investigate the meta-analysis of randomized controlled trials(RCTs) of the efficacy and safety between radiofrequency ablation (RFA ) and surgical resection (SR) in treating small hepatocellular carcinoma (SHCC).

METHODOLOGY

RCTs comparing RFA with SR for SHCC were collected from PubMed/Medline, Cochrane Library, EMBASE and CNKI data base. Odds ratios and 95% confidence intervals were calculated.

RESULTS

Five RCTs with a total of 776 patients were included in this analysis. The 1-, 3-year overall survival rate and 1-year recurrence-free survival rate were of no difference between the RFA and SR . However, SR was shown to be superior to the RFA with the analysis of 5-year overall rate and 3-, 5-year recurrence-free survival rate. The 1-year recurrence rate was similar between the SR and RFA . However, the 2-, 3-year recurrence rate of RFA is significantly higher than SR . In addition, the SR presented a high complication rate.

CONCLUSIONS

SR treatment led to a higher long-term survival rate and a lower long-term recurrence rate, while RFA led to a lower complication rate than SR. However, Further research was needed to investigate the efficacy of RFA because of the inadequate research data and the heterogeneity among the included studies.