Tan Hao-Yang, Gong Jun-Fei, Yu Fei, Tang Wen-Hao, Yang Kang
1 Department of Hepatobiliary Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
2 Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China.
J Laparoendosc Adv Surg Tech A. 2019 Jun;29(6):770-779. doi: 10.1089/lap.2018.0642. Epub 2019 Feb 25.
The aim of this study was to investigate the long-term efficacy of laparoscopic radiofrequency ablation (LRFA) in early hepatocellular carcinoma (HCC) compared with other surgical procedures. A literature search of Cochrane library, PubMed, and Embase through October 2018 was conducted by two investigators (J.-F.G. and F.Y.) independently. The quality of included studies was estimated by the Newcastle-Ottawa Scale. Review Manager 5.3 software was used for meta-analysis, and either fixed- or random-effects model was used according to the heterogeneity of included studies. The chi-square test was used for heterogeneity analysis of included studies, and subgroup analysis was conducted to estimate the heterogeneity between each study and also to estimate the efficacy of different studies. A total of 11 studies involving 1691 patients were included in this analysis. Patients undergoing hepatic resection (HR) had higher 3-, 5-year overall survival rate, 3-year disease-free survival rate, and lower local recurrence rate than those undergoing LRFA. However, patients undergoing LRFA had higher 3-, 5-year overall survival rate than those undergoing other minimally invasive ablation, although there was no statistical difference in local recurrence rate or disease-free survival rate. HR is still an ideal choice for early HCC. If minimally invasive ablation is an alternative treatment, LRFA will be better than other minimally invasive options.
本研究旨在探讨与其他外科手术相比，腹腔镜射频消融术（LRFA）治疗早期肝细胞癌（HCC）的长期疗效。两名研究者（J.-F.G.和F.Y.）于2018年10月独立对Cochrane图书馆、PubMed和Embase进行了文献检索。采用纽卡斯尔-渥太华量表评估纳入研究的质量。使用Review Manager 5.3软件进行荟萃分析，并根据纳入研究的异质性采用固定效应模型或随机效应模型。采用卡方检验对纳入研究进行异质性分析，并进行亚组分析以评估各研究之间的异质性以及不同研究的疗效。本分析共纳入11项研究，涉及1691例患者。接受肝切除术（HR）的患者3年、5年总生存率、3年无病生存率更高，局部复发率低于接受LRFA的患者。然而，接受LRFA的患者3年、5年总生存率高于接受其他微创消融术的患者，尽管局部复发率或无病生存率无统计学差异。HR仍然是早期HCC的理想选择。如果微创消融是一种替代治疗方法，LRFA将优于其他微创选择。
