Percutaneous Radiofrequency Ablation Versus Surgical Resection For Small Hepatocellular Carcinoma: A Meta Analysis

Objective: To evaluate the curative effect of percutaneousradiofrequency ablation(RFA) and surgical resection(SR) for smallhepatocarcinoma.Methods: Clinical data of patients with small hepatocellularcarcinoma underwent radiofrequency ablation or hepatectomy werecollected from computer or manual literature searching, which was carriedout in Cochrane Collaboration, Medline, PubMed, China NationalKnowledge Infrastructure (CNKI), Wanfang and VIP database etc. Metaanalysis that recommended by Cochrane Collaboration was done for thedata obtained, by using the fixed or random effects model. that1287patients who met with the8criteria of enrollment were included in thisstudy. Publication bias was assessed by using a funnel plot.Results: The overall survival rates were significantly lower in patientstreated with RFA than SR after1,3, and5years(respectively: OR,0.62(95%CI,0.43to0.89)ï¼›OR,0.44(95%CI,0.27to0.72)ï¼›OR,0.49(95%CI,0.35to0.68)), a statistically significant difference(P<0.05)ï¼›In the SRgroup, the1,3, and5years disease-free survival rates were significantly higher than the RFA group(respectively: OR,0.63(95%CI,0.43to0.89)ï¼›OR,0.45(95%CI,0.30to0.67)ï¼›OR,0.46(95%CI,0.33to0.64)),a statistically significant difference(P<0.05); The postoperativecomplication of RFA was lower than SR(OR,0.21(95%CI,0.08to0.56)),a statistically significant difference(P<0.05).Conclusion: Though percutaneous Radiofrequency ablation had loweroverall survival rates after surgery and disease-free survival, it has asmaller invasive, shorter hospitalization time and lower incidence ofpostoperative complications. Then RFA will be a good choice for thepatients with hepatocellular carcinoma who are reluctant to treated bysurgical resection.