Efficacy of radiofrequency ablation versus laparoscopic liver resection for hepatocellular carcinoma in China: a comprehensive meta-analysis.

Li, Zhijun; Yu, Qiong; Lu, Xiaozheng; Liu, Yahui; Bai, Jing

doi:10.5114/wiitm.2021.105377

Cited by 10 publications

(18 citation statements)

References 39 publications

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“…RFA and MWA have previously been reported to exhibit comparable complete ablation rates in several tumor types [ 27 – 29 ]. CA can also achieve efficacy similar to that of RFA and MWA in many malignancies [ 30 – 32 ]. CT and US guidance were not associated with any significant differences in PA-associated therapeutic efficacy [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Zhang¹,

Fu²,

Wang³

2022

Videosurgery and Other Miniinvasive Techniques

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Introduction: Imaging-guided percutaneous ablation (PA) is commonly employed for the treatment of patients diagnosed with adrenal metastasis (AM), but comprehensive analyses are essential to validate the efficacy and safety of this approach. Aim: The present meta-analysis was designed to evaluate the safety, efficacy, and long-term outcomes associated with the imaging-guided PA treatment of AM. Material and methods: Relevant studies in the PubMed, Embase, and Wanfang databases published as of June 2022 were identified, and pooled endpoint analyses were performed with Stata 12.0. Results: This meta-analysis included 15 studies. Overall, the respective pooled primary technical success, secondary technical success, local hemorrhage, pneumothorax, hypertension crisis, local recurrence, 1-year overall survival (OS), and 3-year OS rates in study participants were 88%, 93%, 3%, 6%, 6%, 19%, 80%, and 46%. High levels of heterogeneity were evident for the 1-year OS (I 2 = 79.6%) and 3-year OS endpoints (I 2 = 67.1%), but meta-regression analyses failed to identify predictors of these OS rates. Low heterogeneity was observed for subgroups of patients who had undergone cryoablation (I 2 = 0%) or patients with multiple primary cancers (I 2 = 0%) with respect to 1-year OS. Similarly, low heterogeneity for the 3-year OS endpoint was detected in subgroups of patients who had undergone cryoablation (I 2 = 0%), ultrasound-guided PA (I 2 = 0%), individuals with AMs secondary to hepatocellular carcinoma (I 2 = 0%), and patients with multiple primary cancers (I 2 = 0%).Conclusions: These results suggest imaging-guided PA to be a safe and effective treatment for AM associated with satisfactory long-term patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Zhang¹,

Fu²,

Wang³

2022

Videosurgery and Other Miniinvasive Techniques

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“…Based on previous research, there is a recognized need for a comprehensive assessment of the effectiveness and safety of LLR, LRFA, and PRFA in patients with early HCC. While previous meta-analyses (16)(17)(18)(19) have made valuable contributions, they have been limited in study numbers and scope, potentially missing essential insights. For example, Mou-Bo Si et al (16), Shan Jin et al (17), and Xiaocheng Li et al (20) included 6, 7, and 10 studies, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…For example, Mou-Bo Si et al (16), Shan Jin et al (17), and Xiaocheng Li et al (20) included 6, 7, and 10 studies, respectively. In contrast, Zhijun Li et al (19) adopted a more focused approach, scrutinizing Chinese literature and solely including studies from China, with a total of 19 articles (3 in English and 16 in Chinese). However, new studies have emerged in the English literature, providing an opportunity to bolster the impact of the meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of laparoscopic liver resection versus radiofrequency ablation in patients with early and small hepatocellular carcinoma: an updated meta-analysis and meta- regression of observational studies

Abdelgalil,

Amer,

Yasen

et al. 2023

Preprint

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Background Hepatocellular carcinoma (HCC) is the most common type of liver cancer, accounting for 90% of cases worldwide and a significant contributor to cancer-related deaths. This study comprehensively compares the safety and efficacy of laparoscopic liver resection (LLR) versus laparoscopic or percutaneous radiofrequency ablation (LRFA or PRFA) in patients with early and small HCC. Methods We systematically searched Cochrane Library, PubMed, Scopus, and Web of Science databases to include studies comparing LLR versus LRFA or PRFA in patients with early HCC meets the Milan criteria (defined as solitary nodule < 5 cm or three nodules ≤ 3 cm with no extrahepatic spread or vascular invasion). Pooled results were examined for overall survival, disease-free survival, recurrence-free survival, local, intrahepatic and extrahepatic recurrence rates, and complications. We conducted subgroup analyses based on the type of RFA. Meta-regression analyzed the association between overall survival, local recurrence, and various factors. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. We analyzed the data using the R (v.4.3.0) programming language and the "meta" package of RStudio software. Results We included 19 observational studies, compromising 3756 patients. LLR showed higher 5-year overall survival compared to RFA (RR = 1.17, 95% CI [1.06, 1.3], P > 0.01). Our subgroup analysis showed that LLR had higher 5-year survival than PRFA (RR = 1.15, 95% CI [1.02, 1.31], P = 0.03); however, there was no significant difference between LLR and LRFA (RR = 1.26, 95% CI [0.98, 1.63], P = 0.07). LLR was associated with higher disease-free survival) RR = 1.19, 95% CI [1.05, 1.35], P < 0.01; RR = 1.61, 95% CI [1.31, 1.98], P < 0.01(and recurrence-free survival) RR = 1.21, 95% CI [1.09, 1.35], P < 0.01; RR = 1.45, 95% CI [1.15, 1.84], P < 0.01(at 1 and 3 years. LLR was associated with lower local (RR = 0.28, 95% CI [0.16, 0.47], P < 0.01) and intrahepatic recurrence (RR = 0.7, 95% CI [0.5, 0.97], P = 0.03) than RFA. However, complications were significantly higher with LLR (RR = 2.01, 95% CI [1.51, 2.68], P < 0.01). Our meta-regression analysis showed that younger patients had higher risk for local recurrence (P = 0.008), while age wasn't significantly linked to overall survival (P = 0.25). Other covariates like total bilirubin, alpha-fetoprotein levels, and tumor size also showed no significant associations with either overall survival or local recurrence. Conclusion LLR offers improved long-term outcomes and lower recurrence rates than PRFA. However, no significant distinctions were observed between LRFA and LLR in overall survival, recurrence-free survival, and local recurrence. More robust well-designed RCTs are essential to validate our findings.

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“…According to the latest annual data from CANCER TODAY, in 2020, liver cancer was the 6th most common cancer worldwide. Due to the large number of hepatitis B patients, hepatocellular carcinoma (HCC) has become one of the most common malignant tumors in China and severely affects the life and health of patients (1)(2)(3). In recent years, thermal ablation has been rapidly developed as a minimally invasive interventional therapy, and its principle is that for 1 or more specific tumor lesions in an organ, the biological effect of heat will directly lead to the irreversible damage or coagulative necrosis of tumor cells in the lesion tissue.…”

Section: Introductionmentioning

confidence: 99%

The value of contrast-enhanced ultrasound quantitative parameters in the prognosis prediction of hepatocellular carcinoma after thermal ablation: a retrospective cohort study

Gu¹,

Zhang²,

Hu³

et al. 2022

J Gastrointest Oncol

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Background:The postoperative recurrence rate is the main factor affecting the prognosis of hepatocellular carcinoma (HCC) patients, this study sought to investigate the value of contrast-enhanced ultrasound (CEUS) quantitative parameters in predicting the recurrence and the survival of HCC patients after thermal ablation. Methods:The data of 97 patients with pathologically diagnosed HCC who underwent thermal ablation were retrospectively included in this study. The patients had an average age of 46.6 years (range, 23-79 years), and 79 were male and 18 were female. CEUS follow-up was performed at 1-and 3-month after thermal ablation, then at 6-month intervals thereafter for 5 years. CEUS was performed before thermal ablation, and the results were analyzed quantitatively using CEUS perfusion software (VueBox ® , Bracco, Italy). The ratios of the CEUS quantitative parameters between the HCC lesions and reference liver parenchyma were calculated. The parameters included the average contrast signal intensity (MeanLin), peak enhancement (PE), rising time (RT), fall time (FT), time to peak (TTP), mean transit time (mTT), perfusion index (PI), Wash-in Area Under the Curve (WiAUC), Wash-in Rate (WiR), Wash-in Perfusion Index (WiPI), Wash-out Area Under the Curve (WoAUC), Wash-out Rate (WoR), and WiAUC + WoAUC (WiWoAUC). The correlations between the preoperative CEUS quantitative parameter ratios, the blood laboratory indexes, postoperative recurrence, and survival were analyzed using log-rank tests and a Cox regression model. Results:The average follow-up duration period was 79 months (range, 5-145 months). The average recurrence time after ablation was 1-127 months, and the median disease-free survival time was 21 months.The 1-, 3-and 5-year survival rates were 96.9%, 92.3%, and 80.6%, respectively. The log-rank tests showed that tumor size, prothrombin time, and WiAUC, WoAUC, and WiWoAUC ratios were predictors of survival, and aspartate aminotransferase was a predictor of recurrence. The Cox regression analysis showed that tumor size [odds ratio (OR): 6.421; 95% CI: 1.434-28.761] and alanine transaminase (OR: 0.88; 95% CI: 0.010-0.742) were predictors of a poor prognosis.Conclusions: CEUS quantitative parameters before thermal ablation and blood laboratory indexes provide potential clinical value for predicting the postoperative recurrence and survival of HCC patients.

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Efficacy of radiofrequency ablation versus laparoscopic liver resection for hepatocellular carcinoma in China: a comprehensive meta-analysis.

Cited by 10 publications

References 39 publications

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Efficacy and safety of laparoscopic liver resection versus radiofrequency ablation in patients with early and small hepatocellular carcinoma: an updated meta-analysis and meta- regression of observational studies

The value of contrast-enhanced ultrasound quantitative parameters in the prognosis prediction of hepatocellular carcinoma after thermal ablation: a retrospective cohort study

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