Cargando…
Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials
BACKGROUND: Radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) are treatment methods for patients with early-stage hepatocellular carcinoma (HCC) who are not suitable for surgery. Although some reports indicate that RFA is better than PEI, results from previous reviews and analys...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355988/ https://www.ncbi.nlm.nih.gov/pubmed/25889181 http://dx.doi.org/10.1186/s12957-015-0516-7 |
_version_ | 1782360938084564992 |
---|---|
author | Yang, Biao Zan, Rui-yu Wang, Shi-yu Li, Xiang-lian Wei, Mao-ling Guo, Wen-hao You, Xin Li, Jing Liao, Zheng-yin |
author_facet | Yang, Biao Zan, Rui-yu Wang, Shi-yu Li, Xiang-lian Wei, Mao-ling Guo, Wen-hao You, Xin Li, Jing Liao, Zheng-yin |
author_sort | Yang, Biao |
collection | PubMed |
description | BACKGROUND: Radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) are treatment methods for patients with early-stage hepatocellular carcinoma (HCC) who are not suitable for surgery. Although some reports indicate that RFA is better than PEI, results from previous reviews and analyses are inconsistent. Therefore, this meta-analysis was performed to more thoroughly evaluate the effects of these treatments in patients with HCC. METHODS: A literature search was conducted using the Excerpta Medica dataBASE, PubMed, the Cochrane Library, the American Society of Clinical Oncology database, the China National Knowledge Infrastructure database, the Wanfang database, the Chinese Biomedical Literature Database, and the Chongqing VIP database without language limitations. The primary outcome evaluated was overall survival, and secondary outcomes included complete response and local recurrence. Comparisons were made between Asian and European studies. RESULTS: Total pooled and subgroup analyses of Asian studies that included selection biases revealed that RFA is superior to PEI with respect to overall survival (hazard ratio (HR), 0.54; 95% confidence interval (CI), 0.37 to 0.80; P < 0.01) and complete response (relative risk (RR), 1.10; 95% CI 1.03 to 1.18; P < 0.01). However, no significant difference was observed between RFA and PEI in the European studies. In Asian studies, RFA was associated with a lower local recurrence rate than PEI at 1 year (RR, 0.44; 95% CI 0.20 to 0.95; P < 0.05) and 3 years (RR, 0.35; 95% CI 0.22 to 0.55; P < 0.01). However, local recurrence was significantly lower after only 3 years in European studies (RR, 0.50; 95% CI 0.32 to 0.78; P < 0.05). CONCLUSIONS: RFA was only superior to PEI in Asian studies that included selection bias. Thus, there is insufficient evidence to support the idea that RFA is superior to PEI for patients with cirrhotic HCC. Additional large-scale, multicenter, randomized controlled trials that control for selection bias are needed to fully elucidate the optimal treatment method for HCC. |
format | Online Article Text |
id | pubmed-4355988 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43559882015-03-12 Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials Yang, Biao Zan, Rui-yu Wang, Shi-yu Li, Xiang-lian Wei, Mao-ling Guo, Wen-hao You, Xin Li, Jing Liao, Zheng-yin World J Surg Oncol Research BACKGROUND: Radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) are treatment methods for patients with early-stage hepatocellular carcinoma (HCC) who are not suitable for surgery. Although some reports indicate that RFA is better than PEI, results from previous reviews and analyses are inconsistent. Therefore, this meta-analysis was performed to more thoroughly evaluate the effects of these treatments in patients with HCC. METHODS: A literature search was conducted using the Excerpta Medica dataBASE, PubMed, the Cochrane Library, the American Society of Clinical Oncology database, the China National Knowledge Infrastructure database, the Wanfang database, the Chinese Biomedical Literature Database, and the Chongqing VIP database without language limitations. The primary outcome evaluated was overall survival, and secondary outcomes included complete response and local recurrence. Comparisons were made between Asian and European studies. RESULTS: Total pooled and subgroup analyses of Asian studies that included selection biases revealed that RFA is superior to PEI with respect to overall survival (hazard ratio (HR), 0.54; 95% confidence interval (CI), 0.37 to 0.80; P < 0.01) and complete response (relative risk (RR), 1.10; 95% CI 1.03 to 1.18; P < 0.01). However, no significant difference was observed between RFA and PEI in the European studies. In Asian studies, RFA was associated with a lower local recurrence rate than PEI at 1 year (RR, 0.44; 95% CI 0.20 to 0.95; P < 0.05) and 3 years (RR, 0.35; 95% CI 0.22 to 0.55; P < 0.01). However, local recurrence was significantly lower after only 3 years in European studies (RR, 0.50; 95% CI 0.32 to 0.78; P < 0.05). CONCLUSIONS: RFA was only superior to PEI in Asian studies that included selection bias. Thus, there is insufficient evidence to support the idea that RFA is superior to PEI for patients with cirrhotic HCC. Additional large-scale, multicenter, randomized controlled trials that control for selection bias are needed to fully elucidate the optimal treatment method for HCC. BioMed Central 2015-03-08 /pmc/articles/PMC4355988/ /pubmed/25889181 http://dx.doi.org/10.1186/s12957-015-0516-7 Text en © Yang et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Yang, Biao Zan, Rui-yu Wang, Shi-yu Li, Xiang-lian Wei, Mao-ling Guo, Wen-hao You, Xin Li, Jing Liao, Zheng-yin Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title | Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title_full | Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title_fullStr | Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title_full_unstemmed | Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title_short | Radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
title_sort | radiofrequency ablation versus percutaneous ethanol injection for hepatocellular carcinoma: a meta-analysis of randomized controlled trials |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355988/ https://www.ncbi.nlm.nih.gov/pubmed/25889181 http://dx.doi.org/10.1186/s12957-015-0516-7 |
work_keys_str_mv | AT yangbiao radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT zanruiyu radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT wangshiyu radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT lixianglian radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT weimaoling radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT guowenhao radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT youxin radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT lijing radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials AT liaozhengyin radiofrequencyablationversuspercutaneousethanolinjectionforhepatocellularcarcinomaametaanalysisofrandomizedcontrolledtrials |