Radiofrequency Ablation Versus Surgical Resection For Small Hepatocellular Carcinoma (Milan Criteria) In Efficacy And Safety:A Meta Analysis

Objective :Comparison of radiofrequency ablation and surgical resection for small hepatocellular carcinoma clinical efficacy and safety in Milan Criteria.Methods: The databases including Pubmed,Cochrane Library, Embase, CNKI,VIP,CBM,Wangfang were searched,and the related references were consulted.Collecting clinical control study on the little HCC patient which is treated with radiofrequency ablation or surgical resection in Milan Criteria comprehensively.According to the method of Cochrane collaboration network, the Meta analysis is carried out by using RevMan5.3 softwareResults: A total of 11 clinical control study with 2274 patients were included.There was no significant difference in overall survival rate between the RFA group and the SR group at 1 and 3 years,(OR, 0.79 (95% CI, 0.46 to 1,36) , Z test:P=0.39, OR,0.72 (95% CI, 0.50 to 1.02) , Z test: P=0.06)P>0.05.5 year overall survival rate of RFA group was lower than that of SR group (OR, 0.55 (95% CI, 0.41 to 0.73) , Z test: P<0.0001) , the difference was statistically significant(P<0.05).The tumor free survival rate were higher In patients treated with SR than RFA at 1, 3, 5 years, the difference was statistically significant.The incidence of complications was lower in group RFA than in group SR (OR,0.23 (95% CI,0.11 to 0.52),Z test: P=0.0003 ),the difference was statistically significant (P<0.05).Conclusion:Compared with SR,RFA has less complications and higher safety. In the short term the treatment effect of RFA and SR is equivalent,the long-term effect of SR is better than RFA.