小肝癌射频消融与手术切除疗效的Meta分析

目的:对于可以手术的小肝癌患者射频消融和手术切除哪种治疗更适合,一直没有统一的定论,为此本文对两者进行Meta分析?方法:对2000年1月~2009年12月在PubMed?Medline和CNKI上收录的关于小肝癌射频消融与手术切除疗效比较的文献数据进行系统回顾和Meta分析,利用固定效应模型和随机效应模型计算优势比(OR)和95%可信区间(95%Cl)?结果:共选取6篇随机对照研究(RCT)和9篇非随机对照研究(NRCT),这些研究总共包括了2 284例肝癌患者,其中1 213例行射频消融治疗,1 071例行肝切除治疗?射频消融组和肝切除组在1年生存率?1年复发率?3年复发率上没有显著差异(P > 0.05),3年生存率手术组明显高于射频组(P < 0.05)?结论:小肝癌的治疗中射频消融与肝切除相比1年累计生存率及复发率无明显差别,但是就远期生存情况来看,肝切除仍优于射频消融?

Effect of radiofrequency ablation and surgical resection on small hepatocellular carcinoma:a meta-analysis

Objective:There is no clear consensus on the better therapy [radiofrequency ablation (RFA) versus hepatic resection (HR)]for small hepatocellular carcinoma (HCC) eligible for surgical treatments. This study is a meta-analysis of the available evidence. Methods:Systematic review and meta-analysis of trials comparing RFA with HR for small HCC published from January 2000 to December 2009 in PubMed,Medline and CNKI. Pooled odds ratios(OR) with 95% confidence intervals(95% CI) were calculated using either the fixed effects model or random effects model. Results:Six randomized controlled trial,and nine nonrandomized controlled trials studies were included in this analysis. These studies included a total of 2 284 patients:1 213 treated with RFA and 1 071 treated with HR. The difference in overall survival at 1-year was not statistically significant between the RFA and surgery groups(P > 0.05). While the overall survival was significantly higher in patients treated with HR than in those treated with RFA at 3 years.(P < 0.05). And there were no differences in 1-year and 3-year recurrences between the RFA and surgery groups(P > 0.05). Conclusion:HR was superior to RFA in the treatment of patients with small HCC eligible for surgical treatments,particularly for long-term survival rate.