A Meta-analysis Of Curative Effect Of Repeat Hepatic Resection Versus Radiofrequency Ablation For Recurrent Hepatocellular Carcinoma

Objective: Hepatocellular carcinoma is one of the most common malignant tumors and causes of death in malignant tumors in China.Surgical resection is currently the most effective treatment to improve the survival rate of patients.However,the 5-year recurrence rate still as high as 40%-70%.repeat hepatic resection and radiofrequency ablation are the most common treatment methods for recurrent hepatocellular carcinoma,but which one should be preferred is currently inconclusive.This study aims to compare The effect of repeat hepatic resection and radiofrequency ablation on the prognosis of patients with recurrent hepatocellular carcinoma.Methods:Pubmed,Cochrane Library,EMBASE,CBM,CNKI,Wanfang,and VIP were searched for chinese and english articles on repeat hepatic resection and radiofrequency ablation in the treatment of recurrent hepatocellular carcinoma published up to February 2020.Quality assessment was performed for the articles included.And statistical analysis was performed using Rev Man5.3 software.Results: A total of 15 articles with 1603 patients were included after screening,and there were 804 in the radiofrequency ablation group and 799 in the repeat hepatic resection group.The results of Meta-analysis showed that:(1)There were no significant difference in the 1-year survival rates between repeat hepatic resection group and radiofrequency ablation group,but the 3-and 5-year survival rates in repeat hepatic resection group were better than that in radiofrequency ablation group.(1 year: OR = 1.01,95% CI: 0.72 ～ 1.42,P = 0.96;3 years: OR =0.7,95% CI: 0.57 ～ 0.87,P = 0.001;5 years: OR = 0.63,95% CI: 0.50 ～ 0.80,P = 0.0001);(2)There were no significant difference in the 1-year relapse-free survival rate between repeat hepatic resection group and radiofrequency ablation group,but the 3-year relapse-free survival rate was better in repeat hepatic resection group.(1 year: OR = 0.78,95% CI: 0.51 ～ 1.20,P = 0.26;3 years: OR= 0.62,95% CI: 0.47 ～ 0.81,P = 0.0006);(3)The incidence of complications in radiofrequency ablation group was lower than that in repeat hepatic resection group(OR = 0.39,95% CI: 0.28 ～ 0.55;P <0.00001);(4)The hospital stay in radiofrequency ablation group was shorter than that in repeat hepatic resection group(MD =-10.13,95% CI:-14.61 ～-5.65,P <0.00001).Conclusion: For the treatment of recurrent hepatocellular carcinoma,radiofrequency ablation group has fewer complications,less surgical trauma,and shorter hospital stay,while repeat hepatic resection group appeared to be superior in terms of 3-and 5-year overall survival and 3-year relapse-free surviva.