射频消融与肝切除手术治疗小肝癌疗效及安全性的Meta分析

Efficacy and Safety of Radiofrequency Ablation and Hepatectomy in the Treatment of Small Hepatocellular Carcinoma: A Meta Analysis

摘要: 目的：系统评价射频消融和肝切除手术治疗小肝癌的临床效果。方法：通过PubMed、EMBASE、Web of Science、the Cochrane Library等数据库进行搜索，而获得相关射频消融术及外科手术切除治疗小肝癌的随机对照临床试验，年限为2010年至2021年，按照Cochrane系统相关标准对这些研究进行筛选，通过RevMan5.3工具统计分析。结果：本研究共纳入4篇文献，总共597例患者。Meta分析结果显示：在1、3、5年总体生存率及1、3、5年无瘤生存率方面，二组无统计学差异(P > 0.05)；射频消融术组局部肿瘤复发率高于肝切除术组(RR = 1.38, 95% CI: 1.07~1.78, P < 0.05)，肝切除术组并发症发生率高于射频消融术组(RR = 0.49, 95% CI: 0.27~0.87, P < 0.05)。结论：在生存率方面，射频消融术和外科肝切除手术治疗小肝癌的疗效无明显差异；但肝切除术对于控制肿瘤复发更具优势，而射频消融术的并发症少、更具安全性。

Abstract: Objective: To systematically evaluate efficacy and safety of radiofrequency ablation and hepatectomy in the treatment of small hepatocellular carcinoma. Methods: The randomized con-trolled clinical trials of radiofrequency ablation and surgical resection for small liver cancer were searched by searching the databases of PubMed, EMBASE, Web of Science and the Cochrane Library, which lasted from 2010 to 2021. The collected studies were screened and evaluated according to the quality evaluation criteria in the Cochrane system evaluation manual, and the data were statistically analyzed by RevMan5.3 software. Results: A total of 4 randomized controlled trials and 597 patients were included for meta analysis. The results of the Meta analysis showed that there was no significant difference in overall survival rate and disease-free survival rate between radiofrequency ablation and hepatectomy (P > 0.05). The recurrence rate of local tumor in ra-diofrequency ablation group was significantly higher than that in hepatectomy group (RR = 1.38, 95% CI: 1.07~1.78, P < 0.05). The incidence of complications in hepatectomy group was significantly higher than that in radiofrequency ablation group (RR = 0.49, 95% CI: 0.27~0.87, P < 0.05). Conclusions: There is no significant difference in survival rate between radiofrequency ablation and surgical hepatectomy in the treatment of small liver cancer; hepatectomy has more advantages in controlling tumor recurrence, while radiofrequency ablation n has less complications and moresafety.