The prognosis effect of secondary partial hepatectomy and radiofrequency ablation for the patients with recurrent hepatocellular carcinoma: a Meta-analysis
Abstract：Objective To analyze and evaluate the prognosis effect of the secondary partial hepatectomy (RH) and the radiofrequency ablation (RFA) for the patients with recurrent hepatocellular carcinoma (RHCC).Methods According to the advices for system review from the handbook of Cochrance, the randomized controlled trials and the case-control trials comparing the number of survivors in different period with RHCC, who underwent the therapy of RH or RFA, were got through electronic searching in national and international databases from Jan. 1990 to Dec. 2014. The studies which met the inclusive criteria were included and the biases within these studies were analyzed. To calculate the pooled odds ratio (OR), the data of these included studies were extracted, including the numbers of the patients received the therapy of RH or RFA and survivors after these therapies in 1, 3 and 5 years. Q and I2 test were used to analyze the heterogeneity between the included studies. If P>0.05 and I2<50%, it was considered the heterogeneity could be ignored and the fixed effect model would be used, or else the random effect model would be used. Publication biases were analyzed by funnel plots.Results Finally, there were 12 studies which had been included, containing 1 176 patients. Qualitative analysis proved that RH had a better ability to improve the disease-free survival rate. The difference of the prognosis effect of RH and RFA was evaluated with meta-analysis, and the pooled OR and 95% confidence interval (CI) for 1, 3 and 5 years were 1.81(0.82, 4.01), 1.26(0.78, 2.01) and 1.73(1.02, 2.95), respectively, which indicated the difference of the prognosis effect in 1, 3 years was no statistically significant (P>0.05), but that in 5 years was statistically significant (P<0.05).Conclusions RH can distinctly improve the disease-free survival rate of the patients with RHCC, compared with RFA. Though, there is no statistically significant difference between the prognosis effect of RH and RFA for the patients with RHCC in early and middle period, RH still has a better prognosis effect than RFA in general tendency, and for the prognosis effect in late period, RH is doubtless better than RFA. So, compared with RFA, RH has a better ability to improve the prognosis of the patients with RHCC, who can accept the therapy of RH or RFA.
吴黎雳, 宦宏波, 温旭东, 张亮, 杨大鹏, 夏锋. 再次肝脏部分切除与射频消融术对复发性肝细胞癌患者预后影响的Meta分析[J]. 中华解剖与临床杂志, 2015, 20(6): 540-545.
Wu Lili, Huan Hongbo, Wen Xudong, Zhang Liang, Yang Dapeng, Xia Feng. The prognosis effect of secondary partial hepatectomy and radiofrequency ablation for the patients with recurrent hepatocellular carcinoma: a Meta-analysis. Chinese Journal of Anatomy and Clinics, 2015, 20(6): 540-545.
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2015, Vol. 20 
