射频消融对比手术切除治疗孤立性结直肠癌肝转移肿瘤的Meta分析

目的:比较射频消融(RFA)和手术切除对孤立性结直肠癌肝转移的疗效.方法:计算机检索国内外多个数据库,收集RFA和手术切除治疗孤立性结直肠癌肝转移的临床对照试验,按Cochrane系统评价方法对纳入研究的质量进行评价,用RevMan 5.0软件对资料进行Meta分析.结果:最终纳入9个研究,共1 259例患者,其中RFA 440例,手术切除819例.Meta分析结果显示,RFA患者较手术切除患者5年生存率明显降低(P=0.02),术后总体复发率(p=0.01)和局部复发率均明显增高(P=0.003)；两者在治疗直径＜3 cm的肿瘤上术后5年生存率无明显差异(P=0.43).结论:手术切除治疗孤立性结直肠癌肝转移疗效优于RFA,但肿瘤直径＜3 cm时,可考虑采用RFA.

Radiofrequency ablation versus hepatic resection for solitary colorectal liver metastasis: a Meta-analysis

Objective: To compare the therapeutic efficacies between radiofrequency ablation (RFA) and hepatic resection for solitary colorectal liver metastasis.Methods: The controlled clinical trials concerning RFA and hepatic resection for treatment of solitary colorectal liver metastasis were collected through literature retrieval from several native and foreign online databases. The quality of the include studies was assessed according to the Cochrane systematic review method, and data analysis was conducted by using RevMan 5.0 software. Results: Nine studies were finally included, with a total of 1 259 patients, of whom, 440 cases underwent RFA and 819 cases were subjected to surgical resection. The results of Meta-analysis demonstrated that the 5-year overall survival rate was lower, and the overall recurrence and local recurrence rate was higher in patients undergoing RFA than that in patients receiving surgical resection (P=0.02, P=0.01, P=0.003); there was no obvious difference in 5-year overall survival rate after operation between patients undergoing RFA and hepatic resection when the tumor diameter was less than 3 cm (P=0.43).Conclusion: Hepatic resection has a better efficacy than that of RFA for solitary colorectal liver metastasis, but RFA could be considered when tumor diameter is less than 3 cm.