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接受肝切除术联合或不联合射频消融治疗的结直肠癌肝转移患者长期预后的Meta分析

Meta-Analysis of Long-Term Outcomes in Patients with Colorectal Liver Metastases Undergoing Hepatectomy with or without Radiofrequency Ablation.

作者信息

Long Li, Wei Li, Hong Wu

出版信息

Am Surg. 2018 Dec 1;84(12):1913-1923.

Abstract

This meta-analysis aimed to compare the long-term prognosis of patients with colorectal liver metastases undergoing liver resection (LR) with or without radiofrequency ablation (RFA). A systematic search was performed using both medical subject headings and truncated word searches to identify all comparative studies published on this topic. The primary outcomes were postoperative overall survival (OS) and disease-free survival (DFS). Pooled hazard ratios (HR) with 95 per cent confidence intervals (95% CI) were calculated. A total of 10 studies which included 3900 patients were finally enrolled in the meta-analysis. Patients treated by LR gained better OS (HR: 2.07, 95% CI: 1.82-2.37) and DFS (HR: 1.91, 95% CI: 1.70-2.15) than those patients treated by LR + RFA, after pooling unadjusted HRs from the 10 studies. Five studies provided the data of adjusted HR. The pooled results showed that patients in the LR + RFA group had shorter OS (HR: 1.66, 95% CI: 1.18-2.32, = 0.004) but similar DFS (HR: 1.36, 95% CI: 0.99-1.88) compared with patients in the LR group. Our meta-analysis showed that colorectal liver metastases patients who underwent LR gained better long-term outcomes compared with patients undergoing LR + RFA. However, after adjusting confounders, LR + RFA achieved comparable DFS with LR alone.

摘要

本荟萃分析旨在比较接受肝切除术(LR)联合或不联合射频消融(RFA)治疗的结直肠癌肝转移患者的长期预后。通过使用医学主题词和截断词搜索进行系统检索,以识别所有关于该主题发表的比较研究。主要结局指标为术后总生存期(OS)和无病生存期(DFS)。计算合并风险比(HR)及95%置信区间(95%CI)。最终共有10项研究纳入荟萃分析,涉及3900例患者。汇总10项研究未调整的HR后,接受LR治疗的患者比接受LR + RFA治疗的患者获得了更好的OS(HR:2.07,95%CI:1.82 - 2.37)和DFS(HR:1.91,95%CI:1.70 - 2.15)。五项研究提供了调整后HR的数据。汇总结果显示,与LR组患者相比,LR + RFA组患者的OS较短(HR:1.66,95%CI:1.18 - 2.32,P = 0.004),但DFS相似(HR:1.36,95%CI:0.99 - 1.88)。我们的荟萃分析表明,与接受LR + RFA治疗的患者相比,接受LR治疗的结直肠癌肝转移患者获得了更好的长期结局。然而,在调整混杂因素后,LR + RFA与单独LR治疗的DFS相当。

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