Liver resection versus radiofrequency ablation for solitary small hepatocellular carcinoma measuring≤3cm: a systematic review and meta-analysis.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-02-24 DOI:10.1097/JS9.0000000000002302

Ming Yang, Guangjun Li, Kunlin Chen, Youwei Wu, Ting Sun, Wentao Wang

{"title":"Liver resection versus radiofrequency ablation for solitary small hepatocellular carcinoma measuring≤3cm: a systematic review and meta-analysis.","authors":"Ming Yang, Guangjun Li, Kunlin Chen, Youwei Wu, Ting Sun, Wentao Wang","doi":"10.1097/JS9.0000000000002302","DOIUrl":null,"url":null,"abstract":"Background: Controversy remains regarding liver resection (LR) and radiofrequency ablation (RFA) for patients with single hepatocellular carcinomas (HCCs) measuring 3 cm or less. The purpose of our study was to compare the prognosis between LR and RFA in patients with solitary HCCs ≤3 cm.Methods: The meta-analysis followed the PRISMA guidelines and the Cochrane Handbook. All RCTs and cohort studies that compared LR versus RFA in patients with solitary HCCs≤3 cm were comprehensively searched in the PubMed, Cochrane Library, Embase, and Web of Science databases up to 30 January 2024. The primary endpoints were overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS).Results: A total of 6356 patients with solitary HCCs≤3 cm and 5829 patients with solitary HCCs≤2 cm from 39 included studies were analyzed (LR = 5759, RFA = 6426). The present meta-analysis of two RCTs showed no statistically significant difference in OS between LR and RFA. However, the meta-analysis of cohort studies revealed that, compared with RFA, LR conferred a superior OS advantage (HR = 0.80, 95% CI: 0.68-0.93, P = 0.005). There was a significant improvement in the DFS rate with LR over RFA (HR = 0.63, 95% CI: 0.49-0.81) and in the RFS rate (HR = 0.65, 95% CI: 0.55-0.76). Compared with RFA, LR resulted in better OS (HR = 0.73, 95% CI: 0.54-0.97), DFS (HR = 0.74, 95% CI: 0.67-0.82) and RFS (HR = 0.71, 95% CI: 0.57-0.90) in patients with a solitary HCC lesion ≤2 cm.Conclusions: Evidence from cohort studies suggested that in patients with a solitary HCC lesion ≤ 3 cm, LR is preferable to RFA. Additional RCTs are needed to confirm the validity of this evidence.","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":""},"PeriodicalIF":12.5000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JS9.0000000000002302","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Controversy remains regarding liver resection (LR) and radiofrequency ablation (RFA) for patients with single hepatocellular carcinomas (HCCs) measuring 3 cm or less. The purpose of our study was to compare the prognosis between LR and RFA in patients with solitary HCCs ≤3 cm.

Methods: The meta-analysis followed the PRISMA guidelines and the Cochrane Handbook. All RCTs and cohort studies that compared LR versus RFA in patients with solitary HCCs≤3 cm were comprehensively searched in the PubMed, Cochrane Library, Embase, and Web of Science databases up to 30 January 2024. The primary endpoints were overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS).

Results: A total of 6356 patients with solitary HCCs≤3 cm and 5829 patients with solitary HCCs≤2 cm from 39 included studies were analyzed (LR = 5759, RFA = 6426). The present meta-analysis of two RCTs showed no statistically significant difference in OS between LR and RFA. However, the meta-analysis of cohort studies revealed that, compared with RFA, LR conferred a superior OS advantage (HR = 0.80, 95% CI: 0.68-0.93, P = 0.005). There was a significant improvement in the DFS rate with LR over RFA (HR = 0.63, 95% CI: 0.49-0.81) and in the RFS rate (HR = 0.65, 95% CI: 0.55-0.76). Compared with RFA, LR resulted in better OS (HR = 0.73, 95% CI: 0.54-0.97), DFS (HR = 0.74, 95% CI: 0.67-0.82) and RFS (HR = 0.71, 95% CI: 0.57-0.90) in patients with a solitary HCC lesion ≤2 cm.

Conclusions: Evidence from cohort studies suggested that in patients with a solitary HCC lesion ≤ 3 cm, LR is preferable to RFA. Additional RCTs are needed to confirm the validity of this evidence.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.