射频消融术与传统手术治疗小肝癌疗效与安全性的Meta分析

目的 对比射频消融术（radiofrequency ablation，RFA）与传统手术（traditional surgery，TS）在小肝癌中的疗效和安全性。方法 检索国内外公开数据库，检索员至少2人，检索的数据库主要包括：国外数据库如Embase、PubMed、the Cochrane Library，中文数据库如中国知网数据库、中国生物医学文献 数据库、万方数据库、维普数据库。检索射频消融术与传统手术治疗小肝癌的对照试验，年限为2008年 1月至2018年1月，以Cochrane系统评价手册内的质量评价标准进行筛选和评价，用Revman 5.3软件进行 Meta分析。结果 本研究共纳入10篇文献，射频组共1 503例，手术组共1 657例。Meta分析结果表明：在 1年总生存率方面，二组无统计学差异（P＞0.05），而在 3、5年总生存率和1、3、5年无瘤生存率方面，手 术组的生存率高于射频组（P＜0.05）。在并发症方面，射频组并发症发生率低于手术组患者（P＜0.05）。 结论 在长期生存率方面，传统手术对于小肝癌的疗效要优于射频消融术；但射频消融术并发症少，安全 性更高。

Radiofrequency ablation versus traditional surgery for small hepatocellular carcinoma: a Meta- analysis

objective To compare the clinical efficacy and safety between radiofrequency ablation (RFA) and traditional surgery (TS) for small hepatocellular carcinoma (HCC). Methods Public databases were searched by at least two searchers, mainly including EMBASE, PubMed, the Cochrane Library, CNKI database, CBM database, Wanfang database and VIP database. The controlled trials about RFA vs TS in the treatment of small HCC from Jan. 2008 to Jan. 2018 were collected. The quality evaluation criteria in Cochrane Handbook for Systematic Reviews were used for selection and evaluation. Meta-analysis was carried out with RevMan5.3 software. Results A total of 10 studies were included: 1 503 cases were in RFA group and 1 657 cases in TS group. Meta-analysis showed that there was no significant difference in 1-year survival rate between the two groups, but TS group had a higher 3-year and 5-year overall survival rate, as well as higher 1-year, 3-year, and 5-year tumor free survival rates compared with those of RFA group (P<0.05). Conclusion In terms of longterm survival, TS is superior to RFA for small HCC, but radiofrequency ablation has less complications and more safety.