The Long-Term Efficacy of Radiofrequency Ablation Versus Laparoscopic Hepatectomy for Small Hepatocellular Carcinoma in East Asia: A Systematic Review and Meta-Analysis
Vol. 22 No. 7 (2020), Systematic reviews
Vol. 22 No. 7 (2020)

The Long-Term Efficacy of Radiofrequency Ablation Versus Laparoscopic Hepatectomy for Small Hepatocellular Carcinoma in East Asia: A Systematic Review and Meta-Analysis

Systematic reviews
Published 2020-07-27
Xiaozheng Lu
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital, Jilin University, Changchun, China
Zhijun Li
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
Yahui Liu
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital, Jilin University, Changchun, China
Zishuai Wang
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital, Jilin University, Changchun, China
Fenghui Peng
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital, Jilin University, Changchun, China
Qiong Yu
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
Xueqi Fu
Edmond H. Fischer Signal Transduction Laboratory, School of Life Sciences, Jilin University, Changchun, China
Bai Ji
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital, Jilin University, Changchun, China
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Keywords

Radiofrequency Ablation
Minimally Invasive Surgery
Laparoscopic Hepatectomy
Hepatocellular Carcinomas
Meta-Analysis

How to Cite

Lu , X., Li , Z. ., Liu , Y. ., Wang , Z. ., Peng , F. ., Yu, Q. ., Fu, X. . ., & Ji, B. . (2020). The Long-Term Efficacy of Radiofrequency Ablation Versus Laparoscopic Hepatectomy for Small Hepatocellular Carcinoma in East Asia: A Systematic Review and Meta-Analysis. Iranian Red Crescent Medical Journal, 22(7). Retrieved from https://ircmj.com/index.php/IRCMJ/article/view/732
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Abstract

Context: Hepatocellular carcinoma (HCC) is a common malignant cancer and the second leading cause of cancer-related deaths around the world. Radiofrequency ablation (RFA) and laparoscopic hepatectomy (LH) have been adopted for the treatment of HCC. The aim of the meta-analysis was to explore the long-term efficacy of RFA compared with LH for small HCC (sHCC) patients in the East Asian population.

Evidence Acquisition: We performed a systematic review and meta-analysis by the literature search on PubMed, Cochrane Library, EMBASE, Chinese Biological Medical Literature (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wanfang from their inception until October 10, 2019, for comparing the long-term efficacy outcomes of RFA with LH.

Results: Fourteen retrospective studies with 1,390 subjects were included in the meta-analysis. Compared with the LH-treated group, RFA could raise the local recurrence rate under median follow-up duration and reduce disease-free survival (DFS) rates at 1 - 3 years. However, it failed to affect 5-year overall survival (OS) and DFS rates. In the subgroup analyses, different RFA approaches

had significantly higher local recurrence rates than the LH group. A similar effect on OS and DFS rates within five years for single early (≤ 3 cm) HCCs and on the 1- and 5-year DFS rates for nodules ≤ 5 cm were observed between the two groups, but RFA approaches could reduce the 3-y OS and DFS rates for single nodules ≤ 5 cm. The percutaneous radiofrequency ablation (PRFA) group had signif-icantly lower 3- and 5-year OS and the 1- and 3-year DFS rates than the LH group, while no significant difference in OS and DFS rates in the laparoscopic radiofrequency ablation (LRFA) approach. The RFA approach improved the 3-year OS compared with the LH group in Japan, but reduced the 3-year OS and DFS rates within 3 years in China.

Conclusions: Our results support that LH treating sHCC had a better long-term efficacy and a lower local recurrence rate than RFA in the East Asian population. Further high-quality prospective studies are required to confirm the long-term efficacy.

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References

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