A meta-analysis of long-term survival outcomes between surgical resection and radiofrequency ablation in patients with single hepatocellular carcinoma ≤ 2 cm (BCLC very early stage). (August 2018)

• Record Type: Journal Article
• Authors: Yin, Zi; Jin, Haosheng; Ma, Tingting; Zhou, Yu; Yu, Min; Jian, Zhixiang
• Is Part Of: International journal of surgery. Volume 56(2018)
• Page Start: 61
• Page End: 67
• Publication Date: 2018-08
• Subjects: Hepatocellular carcinoma -- BLCL very early stage -- Liver resection (RES) -- Radiofrequency ablation (RFA); Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.04.048
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Introduction: The optimal management choice in consideration of long-term overall survival (OS) and disease-free survival (DFS) for patients with BLCL very early stage is a matter of debate. Aim: A systematic review and meta-analysis was conducted to evaluate the efficacy of liver resection (RES) and radiofrequency ablation (RFA) for single HCC 2 cm or less. Material and method: The primary sources of the reviewed studies through December 2017, without restriction on the languages or regions, were Pubmed and Embase. The hazard ratio (HR) was used as a summary statistic for long-term outcomes. Results: A total of 5 studies qualified for inclusion in this quantified meta-analysis with a total of 729 HCC patients of BCLC very early stage. Only postoperative 1-year OS was comparable in both RES and RFA groups. As for long-term outcomes of 3-year and 5-year OSs, RES was significantly better than RFA, the HRs were 0.64 (95%CI: 0.41, 1.00; P = 0.05) and 0.63 (95%CI: 0.42, 0.95; P = 0.03) respectively. In terms of postoperative DFS, reduced tumor recurrence was observed in RES, and all the short- and long-terms outcomes were favored RES. Discussion: RES offers better long-term oncologic outcomes compared with RFA in current clinical evidences. Highlights: Long-term survival for patients with BCLC very early stage is in debate. RES offers better long-term oncological outcomes compared with RFA. RES should be the preferred treatment when transplantation is not readily available.