Cicerone Ottavia, Mantovani Stefania, Oliviero Barbara, Basilico Giorgia, Corallo Salvatore, Quaretti Pietro, Maestri Marcello
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy.
Department of Infectious Diseases-Clinical Immunology, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy.
World J Clin Oncol. 2025 May 24;16(5):105881. doi: 10.5306/wjco.v16.i5.105881.
Hepatocellular carcinoma (HCC) is among the most aggressive primary liver cancers, leading to significant global mortality. While early diagnosis improves prognosis, treatment decisions, particularly between surgical resection and radiofrequency ablation (RFA), remain controversial.
To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival (OS).
We included studies comparing liver resection and RFA, excluding case reports, editorials, and studies without relevant outcomes. A systematic search in PubMed and Web of Science identified 197 studies. Abstracts underwent sentiment analysis using Python's Natural Language Toolkit library, categorizing them as favoring resection, ablation, or neutral. We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios (HRs) for OS.
Sentiment analysis revealed that 75.1% of abstracts were neutral, 14.2% favored resection, and 10.7% favored RFA. The meta-analysis showed a significant survival advantage for liver resection, with a pooled HR of 0.5924 (95% confidence interval: 0.540-0.649). Heterogeneity was moderate (² = 39.98%). Despite the meta-analysis demonstrating clear survival benefits of liver resection, most abstracts maintained a neutral stance. This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.
The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions. Liver resection remains the preferred treatment for HCC in eligible patients.
肝细胞癌（HCC）是最具侵袭性的原发性肝癌之一，在全球导致大量死亡。虽然早期诊断可改善预后，但治疗决策，尤其是在手术切除和射频消融（RFA）之间的选择，仍存在争议。
通过对医学文献的情感分析以及对总生存期（OS）的荟萃分析来阐明这一问题。
我们纳入了比较肝切除和RFA的研究，排除病例报告、社论以及无相关结局的研究。在PubMed和Web of Science中进行系统检索，共识别出197项研究。使用Python的自然语言工具包库对摘要进行情感分析，将其分类为支持切除、支持消融或中立。我们还对11项报告OS风险比（HRs）的研究采用随机效应模型进行了荟萃分析。
情感分析显示，75.1%的摘要为中立，14.2%支持切除，10.7%支持RFA。荟萃分析显示肝切除具有显著的生存优势，合并HR为0.5924（95%置信区间：0.540 - 0.649）。异质性为中度（I² = 39.98%）。尽管荟萃分析表明肝切除具有明确的生存益处，但大多数摘要仍保持中立立场。这种差异凸显了在得出明确结论时可能存在的偏差或犹豫。
该研究强调临床医生需要将有力的统计证据置于叙述性印象之上。对于符合条件的HCC患者，肝切除仍然是首选治疗方法。
