射频消融术与肝切除术对治疗米兰标准小肝癌临床疗效的Meta分析

目的比较射频消融术(Radiofrequency ablation,RFA)与手术切除术治疗(Surgical resection,SR)米兰标准下小肝癌的临床有效性和安全性。方法利用计算机和人工检索的方式检索Pub Med、The Cochrane Library、Embase、CNKI、维普期刊、万方数据、中国生物医学文献数据库(CBM),全面搜集射频消融术与手术切除治疗米兰标准下小肝癌的临床对照研究。按照Cochrane协作网提供的方法用Rev Man5.3软件进行Meta分析。结果一共检索出11篇文献,2274名患者纳入此次研究,其中RFA组1160名,SR组1114。RFA组与SR组1、3年总体生存率(OR,0.79(95%CI,0.46 to 1.36),Z检验:P=0.39,OR,0.72(95%CI,0.50 to 1.02),Z检验:P=0.06)无统计学差异(P0.05),5年总体生存率RFA组低于SR组(OR,0.55(95%CI,0.41 to 0.73),Z检验:P0.0001),差异有统计学意义(P0.05)。SR组在1、3、5年无瘤生存率中比RFA组更高,差异有统计学意义。RFA组比SR组的并发症发生率低(OR,0.23(95%CI,0.11 to 0.52),Z检验:P=0.0003),安全性更高。结论 RFA相较于SR有更少的并发症,安全性更高。就短期来说RFA与SR的治疗效果相当,长期效果而言SR疗效是优于RFA的。

Radiofrequency ablation versus surgical resection for small hepatocellular carcinoma in Milan Criteria:A meta analysis

Objective Comparison of radiofrequency ablation and surgical resection for small hepatocellular carcinoma clinical efficacy and safety inMilan Criteria.Methods The databases including Pubmed,Cochrane Library,Embase,CNKI,VIP,CBM,Wangfang were searched,and the related references were consulted.Collecting clinical control study on the little HCC patient which is treated with radiofrequency ablation or surgical resection in Milan Criteria comprehensively.According to the method of Cochrane collaboration network,the Meta analysis is carried out by using RevMan5.3 software.Results A total of 11 clinical control study with 2274 patients were included.There was no significant difference in overall survival rate between the RFA group and the SR group at 1 and 3 years,(OR,0.79(95％ CI,0.46 to 1.36),Z test:P =0.39,OR,0.72(95％ CI,0.50 to 1.02),Z test:P =0.06)P ＞0.05.5year overall survival rate of RFA group was lower than that of SR group (OR,0.55 (95 ％ CI,0.41 to 0.73),Z test:P ＜ 0.0001),the difference was statistically significant(P ＜0.05).The tumor free survival rate were higher in patients treated with SR than RFA at 1,3,5 years,the difference was statistically significant.The incidence of complications was lower in group RFA than in group SR(OR,0.23(95％ CI,0.11 to0.52),Ztest:P=0.0003),the difference was statistically significant(P ＜0.05).Conclusion Compared with SR,RFA has less complications and higher safety.In the short term,the treatment effect of RFA and SR is equivalent,the longterm effect of SR is better than RFA.