Radiofrequency Ablation Versus Reresection in Treating Recurrent Hepatocellular Carcinoma: A Meta-Analysis

Treatment for recurrent hepatocellular carcinoma (RHCC) remains controversial. This study tried to compare survival benefits between radiofrequency ablation (RFA) and reresection for RHCC patients following curative surgical treatments. Databases were searched for comparative studies published from 2008 to 2014 on RFA versus reresection in treating RHCC. Meta-analysis was performed using a random or fixed-effect model to compare the overall survivals (OSs) and disease-free survivals (DFSs) between RFA and reresection. Begg funnel plot and Egger test were performed to assess the publication bias. Six retrospective comparative studies fulfilled our criteria and were included. For patients with RHCC, RFA was equivalent to reresection in 1-year OSs (odds ratio [OR] 0.86; 95% confidence interval [CI], 0.50–1.49; P = 0.587), 3-year OSs (OR 0.91; 95% CI, 0.64–1.28; P = 0.581), and 5-year OSs (OR 0.97; 95% CI, 0.69–1.36; P = 0.846). However, reresection was superior to RFA in 3-year DFSs (OR 2.25; 95% CI, 1.37–3.68; P = 0.001) and 5-year DFSs (OR 3.70; 95% CI, 1.98–6.93; P = 0.000). The outcome of 1-year DFSs was unstable with statistical heterogeneity among studies included in meta-analysis (I(2) = 77.4%). No evidence of publication bias was found. RFA was considered as a less invasive modality for RHCC patients. RFA achieves comparable OSs as reresection in the treatment of RHCC, with lower postoperative complications.