Hao Wu, Binbin Jiang, Wei Yang, Kun Yan
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China.
Front Oncol. 2020 Nov 17;10:561669. doi: 10.3389/fonc.2020.561669. eCollection 2020.
Radiofrequency ablation (RFA) can be a favorable option for patients with colorectal liver metastasis (CRLM). However, current reports about the therapeutic efficacy of liver resection (LR) and RFA for colorectal liver metastasis (CRLM) still remain controversial, especially for solitary CRLM. Therefore, this meta-analysis was performed to evaluate the therapeutic efficacy between LR and RFA for solitary CRLM. First, a comprehensive search for published studies was conducted using PubMed, the Cochrane Library Central, and Web of Science. Each study was reviewed and data extracted. In this meta-analysis, 10 studies (11 study arms) were finally included. The meta-analysis was performed using risk ratio (RR) and random effect model or fixed effect model, in which 95% confidence intervals (95% CI) for RR were calculated. The primary outcomes were disease-free survival (DFS) and overall survival (OS) at 1, 3, or 5 years plus complication rate. The results showed that patients treated by LR achieved better PFS and OS than those by RFA, but subgroup analysis and meta-regression displayed that the efficacy of RFA was equivalent to that of LR in solitary CRLM, when conditions were limited to tumors of ≤ 3 cm and fewer synchronous metastasis in the publication years 2011-2018. Meanwhile, RFA achieved lower complication rates when compared with LR. In conclusion, although patients treated by RFA cannot achieve better PFS and OS than those by LR, RFA can be considered a viable treatment option for solitary CRLM, with potentially lower complication rates.
射频消融（RFA）对于结直肠癌肝转移（CRLM）患者可能是一种不错的选择。然而，目前关于肝切除术（LR）和RFA治疗结直肠癌肝转移（CRLM）疗效的报道仍存在争议，尤其是对于孤立性CRLM。因此，进行了这项荟萃分析以评估LR和RFA治疗孤立性CRLM的疗效。首先，使用PubMed、Cochrane图书馆中央数据库和科学网对已发表的研究进行全面检索。对每项研究进行审查并提取数据。在这项荟萃分析中，最终纳入了10项研究（11个研究组）。使用风险比（RR）和随机效应模型或固定效应模型进行荟萃分析，计算RR的95%置信区间（95%CI）。主要结局为1年、3年或5年的无病生存期（DFS）和总生存期（OS）以及并发症发生率。结果显示，接受LR治疗的患者比接受RFA治疗的患者获得了更好的无进展生存期（PFS）和总生存期（OS），但亚组分析和荟萃回归显示，在2011 - 2018年发表的研究中，当条件限制为肿瘤≤3 cm且同步转移较少时，RFA在孤立性CRLM中的疗效与LR相当。同时，与LR相比，RFA的并发症发生率更低。总之，虽然接受RFA治疗的患者在PFS和OS方面不如接受LR治疗的患者，但RFA可被视为孤立性CRLM的一种可行治疗选择，其并发症发生率可能更低。
