Zhang Xiong, Zhu Hong-Yi, Yuan Ming
Department of Nursing, Guizhou Nursing Vocational College, Guiyang 550025, Guizhou Province, China.
Department of Hepatobiliary Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2986-2995. doi: 10.4240/wjgs.v16.i9.2986.
Primary liver cancer is one of the most lethal malignancies in the world. Traditional treatment methods have limitations in terms of efficacy and safety. Radiofrequency ablation (RFA) guided by B-ultrasound, as a minimally invasive treatment, has attracted increasing attention in the treatment of primary liver cancer in recent years.
To study the efficacy and safety of RFA were compared with those of traditional surgery (TS) for treating small liver cancer.
At least 2 people were required to search domestic and foreign public databases, including foreign databases such as EMBASE, PubMed and the Cochrane Library, and Chinese databases such as the China National Knowledge Infrastructure database, China Biomedical Literature database, Wanfang database and VIP database. Controlled trials of RFA conventional surgery for small liver cancer were retrieved from January 2008 to January 2023. They were screened and evaluated according to the quality evaluation criteria in the Cochrane Handbook of Systematic Reviews. The meta-analysis was performed using RevMan 5.3 software.
A total of 10 studies were included in this study, including 1503 patients in the RFA group and 1657 patients in the surgery group. The results of the meta-analysis showed that there was no significant difference in 1-year overall survival between the two groups ( > 0.05), while the 3-year and 5-year overall survival rates and 1-year, 3-year and 5-year tumor-free survival rates in the surgery group were greater than those in the RFA group ( < 0.05). In terms of complications, the incidence of complications in the RFA group was lower than that in the surgery group ( < 0.05).
In terms of long-term survival, TS is better than RFA for small liver cancer patients. However, RFA has fewer complications and is safer.
原发性肝癌是全球最致命的恶性肿瘤之一。传统治疗方法在疗效和安全性方面存在局限性。近年来，B超引导下的射频消融术（RFA）作为一种微创治疗方法，在原发性肝癌的治疗中受到越来越多的关注。
比较RFA与传统手术（TS）治疗小肝癌的疗效和安全性。
至少两人检索国内外公共数据库，包括EMBASE、PubMed和Cochrane图书馆等国外数据库，以及中国知网数据库、中国生物医学文献数据库、万方数据库和维普数据库等中文数据库。检索2008年1月至2023年1月期间RFA与传统手术治疗小肝癌的对照试验。根据Cochrane系统评价手册中的质量评价标准进行筛选和评价。使用RevMan 5.3软件进行荟萃分析。
本研究共纳入10项研究，其中RFA组1503例患者，手术组1657例患者。荟萃分析结果显示，两组1年总生存率无显著差异（>0.05），而手术组的3年和5年总生存率以及1年、3年和5年无瘤生存率均高于RFA组（<0.05）。在并发症方面，RFA组并发症发生率低于手术组（<0.05）。
对于小肝癌患者，在长期生存方面，TS优于RFA。然而，RFA并发症较少，更安全。
