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CN 22-1108/R
Volume 37 Issue 5
May  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(5): 1103-1109

Clinical effect of re-hepatic resection versus radiofrequency ablation in treatment of recurrent hepatocellular carcinoma in Asia: A Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2021.05.025

  • Department of Hepatobiliary Surgery, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning 530021, China

Research funding:

 (82060510);

 (81960308);

 (2018GXNSFBA138018);

 (2018GXNSFAA050124);

 (桂科AB18126055);

 (2019AQ20);

 (2019M663876XB);

 

  • Received Date: 2020-10-30
  • Accepted Date: 2020-12-10
  • Published Date: 2021-05-20
    Abstract
  •   Objective  To investigate the safety and efficacy of re-hepatic resection (rHR) versus radiofrequency ablation (RFA) in the treatment of recurrent hepatocellular carcinoma (RHCC) in Asia through a meta-analysis.  Methods  PubMed, CNKI, and Wanfang Data were searched for related studies published up to June 15, 2020. Two reviewers independently searched for the articles and extracted related data, and RevMan 5.4.1 was used to perform the meta-analysis.  Results  A total of 2 randomized controlled trials and 18 retrospective cohort studies met the inclusion criteria and involved 2903 patients with RHCC from Asian countries. The mortality rate in the perioperative period was 2% in the rHR group and 0 in the RFA group, and the incidence rate of perioperative complications was 22.4% in the rHR group and 3.3% in the RFA group. The 1-, 3-, and 5-year overall survival rates were 92.3%, 66.3%, and 51.1%, respectively, in the rHR group and 91.4%, 69.2%, and 39.9%, respectively, in the RFA group. The 1-, 3-, and 5-year disease-free survival rates were 67.9%, 48.3%, and 34.4%, respectively, in the rHR group and 57.5%, 27.9%, and 14.0%, respectively, in the RFA group. The Meta-analysis showed that there was no significant difference in overall survival rate between the two groups (hazard ratio [HR]=0.89, 95% confidence interval [CI]: 0.77-1.02, P=0.10), while the rHR group had a significantly higher disease-free survival rate than the RFA group (HR=0.79, 95% CI: 0.72-0.87, P < 0.001).  Conclusion  Current evidence shows that rHR may help to achieve a higher disease-free survival rate than RFA in the treatment of RHCC, while rHR and RFA have a similar overall survival rate.

     

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  • [1]
    WANG YY, LIU JM, WANG LJ, et al. Prognostic value of tumor burden score in patients with hepatocellular carcinoma[J]. Chin J Oncol Prev Treat, 2019, 11(5): 393-397. DOI: 10.3969/j.issn.1674-5671.2019.05.06.

    王言焱, 刘佳明, 王立军, 等. 肿瘤负荷评分在肝细胞癌患者预后预测中的价值[J]. 中国癌症防治杂志, 2019, 11(5): 393-397. DOI: 10.3969/j.issn.1674-5671.2019.05.06.
    [2]
    European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma[J]. J Hepatol, 2018, 69(1): 182-236. DOI: 10.1016/j.jhep.2018.03.019.
    [3]
    WANG K, LIU G, LI J, et al. Early intrahepatic recurrence of hepatocellular carcinoma after hepatectomy treated with re-hepatectomy, ablation or chemoembolization: A prospective cohort study[J]. Eur J Surg Oncol, 2015, 41(2): 236-242. DOI: 10.1016/j.ejso.2014.11.002.
    [4]
    SUN WC, CHEN IS, LIANG HL, et al. Comparison of repeated surgical resection and radiofrequency ablation for small recurrent hepatocellular carcinoma after primary resection[J]. Oncotarget, 2017, 8(61): 104571-104581. DOI: 10.18632/oncotarget.21604.
    [5]
    UMEDA Y, MATSUDA H, SADAMORI H, et al. A prognostic model and treatment strategy for intrahepatic recurrence of hepatocellular carcinoma after curative resection[J]. World J Surg, 2011, 35(1): 170-177. DOI: 10.1007/s00268-010-0794-8.
    [6]
    SONG KD, LIM HK, RHIM H, et al. Repeated hepatic resection versus radiofrequency ablation for recurrent hepatocellular carcinoma after hepatic resection: A propensity score matching study[J]. Radiology, 2015, 275(2): 599-608. DOI: 10.1148/radiol.14141568.
    [7]
    LIANG HH, CHEN MS, PENG ZW, et al. Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: A retrospective study[J]. Ann Surg Oncol, 2008, 15(12): 3484-3493. DOI: 10.1245/s10434-008-0076-y.
    [8]
    HO CM, LEE PH, SHAU WY, et al. Survival in patients with recurrent hepatocellular carcinoma after primary hepatectomy: Comparative effectiveness of treatment modalities[J]. Surgery, 2012, 151(5): 700-709. DOI: 10.1016/j.surg.2011.12.015.
    [9]
    CHAN AC, POON RT, CHEUNG TT, et al. Survival analysis of re-resection versus radiofrequency ablation for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma[J]. World J Surg, 2012, 36(1): 151-156. DOI: 10.1007/s00268-011-1323-0.
    [10]
    CHEN S, PENG Z, XIAO H, et al. Combined radiofrequency ablation and ethanol injection versus repeat hepatectomy for elderly patients with recurrent hepatocellular carcinoma after initial hepatic surgery[J]. Int J Hyperthermia, 2018, 34(7): 1029-1037. DOI: 10.1080/02656736.2017.1387941.
    [11]
    CEN F. Analysis of curative effect of repeated hepatectomy for recurrent HCC[D]. Hangzhou: Zhejiang University School of Medicine, 2016.

    岑峰. 复发性肝癌行再次肝切除术治疗的疗效分析研究[D]. 杭州: 浙江大学, 2016.
    [12]
    CHEN K, LIU XY, TENG YX, et al. Rehepatectomyand radiofrequency ablation for patients with recurrent hepatocellular carcinoma[J]. Chin J Practic Surg, 2019, 39(10): 1060-1064. DOI: 10.19538/j.cjps.issn1005-2208.2019.10.16.

    陈康, 刘新宇, 滕煜宪, 等. 再次肝切除与射频消融治疗复发性肝癌疗效对比研究[J]. 中国实用外科杂志, 2019, 39(10): 1060-1064. DOI: 10.19538/j.cjps.issn1005-2208.2019.10.16.
    [13]
    HUANG XH, HUANG Y, LIN KC, et al. The curative efficacy comparison of percntaneons radiofrequency ablation versus surgical re-resection for recurrent small hepatocellular carcinoma[J]. J Abdominal Surg, 2013, 26(2): 93-95. DOI: 10.3969/j.issn.1003-5591.2013. 02.008.

    黄新辉, 黄尧, 林科灿, 等. 复发性小肝细胞癌射频消融与再手术切除疗效的分析[J]. 腹部外科, 2013, 26(2): 93-95. DOI: 10.3969/j.issn.1003-5591.2013. 02.008.
    [14]
    LIANG HH, PENG ZW, CHEN MS, et al. Effects of percutaneous radiofrequency ablation and repeat hepatectomy for the treatment of solitary recurrent hepatocelluar carcinoma with the diameter no more than 3 cm[J]. Chin J Dig Surg, 2011, 10(1): 36-39. DOI: 10.3760/cma.j.issn. 1673-9752. 2011.01.010.

    梁惠宏, 彭振维, 陈敏山, 等. 经皮射频消融与再手术治疗单个直径≤3 cm的复发性肝癌的疗效比较[J]. 中华消化外科杂志, 2011, 10(1): 36-39. DOI: 10.3760/cma.j.issn.1673-9752. 2011.01.010.
    [15]
    REN ZG, GAN YH, FAN J, et al. Treatment of postoperative recurrence of hepatocellular carcinoma with radiofrequency ablation comparing with repeated surgical resection[J]. Chin J Surg, 2008, 46(21): 1614-1616. DOI: 10.3321/j.issn:0529-5815.2008.21.005.

    任正刚, 干育红, 樊嘉, 等. 射频毁损术与再手术切除治疗复发性小肝癌对照研究[J]. 中华外科杂志, 2008, 46(21): 1614-1616. DOI: 10.3321/j.issn:0529-5815.2008.21.005.
    [16]
    TIAN ZL. Investigate the efficacy between radiofrequency ablation and surgical resection in the treatment of small recurrent hepatocellular carcinoma: An retrospective analysis of 57 cases[D]. Nanning: Guangxi Medical University, 2016.

    田正灵. 射频消融与手术切除治疗复发性小肝细胞性肝癌的疗效比较分析(附57例病例分析)[D]. 南宁: 广西医科大学, 2016.
    [17]
    ZHANG H, XU XB, HE XJ, et al. Compare of the efficacy between re-operative and radiofrequency ablation on postoperative recurrent carcinoma[J]. Med J West China, 2013, 25(12): 1816-1818. DOI: 10.3969/j.issn.1672-3511.2013.12.019.

    张辉, 徐新保, 何晓军, 等. 原发性肝癌术后复发再手术切除与射频消融治疗的疗效比较[J]. 西部医学, 2013, 25(12): 1816-1818. DOI: 10.3969/j.issn.1672-3511.2013.12.019.
    [18]
    ZHANG TT, LI KY, LUO HC, et al. Long-term outcomes of percutaneous microwave ablation versus repeat hepatectomy for treatment of late recurrent small hepatocellular carcinoma: A retrospective study[J]. Natl Med J China, 2014, 94(33): 2570-2572. DOI: 10.3760/cma. j.issn.0376-2491.2014.33.004.

    张婷婷, 李开艳, 罗鸿昌, 等. 经皮微波消融和二次手术治疗晚期复发型小肝癌的长期疗效观察[J]. 中华医学杂志, 2014, 94(33): 2570-2572. DOI: 10.3760/cma.j.issn.0376-2491. 2014.33.004.
    [19]
    PENG Z, WEI M, CHEN S, et al. Combined transcatheter arterial chemoembolization and radiofrequency ablation versus hepatectomy for recurrent hepatocellular carcinoma after initial surgery: A propensity score matching study[J]. Eur Radiol, 2018, 28(8): 3522-3531. DOI: 10.1007/s00330-017-5166-4.
    [20]
    LU LH, MEI J, KAN A, et al. Treatment optimization for recurrent hepatocellular carcinoma: Repeat hepatic resection versus radiofrequency ablation[J]. Cancer Med, 2020, 9(9): 2997-3005. DOI: 10.1002/cam4.2951.
    [21]
    XIA Y, LI J, LIU G, et al. Long-term effects of repeat hepatectomy vs percutaneous radiofrequency ablation among patients with recurrent hepatocellular carcinoma: A randomized clinical trial[J]. JAMA Oncol, 2020, 6(2): 255-263. DOI: 10.1001/jamaoncol.2019.4477.
    [22]
    LIU JL, HUANG D, CAO L, et al. Laparoscopic hepatectomy versus radiofrequency ablation in treatment of recurrent hepatocellular carcinoma: A prospective randomized control study based on interim follow-up analysis[J]. J Third Milit Med Univ, 2019, 41(5): 467-472. DOI: 10.16016/j.1000-5404.201811005.

    刘嘉龙, 黄登, 曹利, 等. 腹腔镜肝切除术和射频消融术治疗复发性肝癌的前瞻性随机对照研究(中期随访分析)[J]. 第三军医大学学报, 2019, 41(5): 467-472. DOI: 10.16016/j.1000-5404.201811005.
    [23]
    CHAN AC, CHAN SC, CHOK KS, et al. Treatment strategy for recurrent hepatocellular carcinoma: Salvage transplantation, repeated resection, or radiofrequency ablation?[J]. Liver Transpl, 2013, 19(4): 411-419. DOI: 10.1002/lt.23605.
    [24]
    CHEN R, GAN Y, GE N, et al. Transarterial chemoembolization versus radiofrequency ablation for recurrent hepatocellular carcinoma after resection within barcelona clinic liver cancer stage 0/A: A retrospective comparative study[J]. J Vasc Interv Radiol, 2016, 27(12): 1829-1836. DOI: 10.1016/j.jvir.2016.06.010.
    [25]
    HIROKAWA F, HAYASHI M, MIYAMOTO Y, et al. Appropriate treatment strategy for intrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma[J]. J Gastrointest Surg, 2011, 15(7): 1182-1187. DOI: 10.1007/s11605-011-1484-z.
    [26]
    WANG N, ZHENG JL, JIANG L. Clinical effect of surgical resection versus radiofrequency ablation in treatment of multiple liver cancer in different liver segments meeting the Milan criteria[J]. J Clin Hepatol, 2020, 36(4): 792-797. DOI: 10.3969/j.issn.1001-5256.2020.04.017.

    王宁, 郑金利, 蒋利. 手术切除与射频消融治疗符合米兰标准的不同肝段多发肝癌的效果分析[J]. 临床肝胆病杂志, 2020, 36(4): 792-797. DOI: 10.3969/j.issn.1001-5256.2020.04.017.
    [27]
    DUAN C, LIU M, ZHANG Z, et al. Radiofrequency ablation versus hepatic resection for the treatment of early-stage hepatocellular carcinoma meeting Milan criteria: A systematic review and meta-analysis[J]. World J Surg Oncol, 2013, 11(1): 190. DOI: 10.1186/1477-7819-11-190.
    [28]
    LIN SM, LIN CJ, LIN CC, et al. Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less[J]. Gut, 2005, 54(8): 1151-1156. DOI: 10.1136/gut.2004.045203.
    [29]
    PENG ZW, ZHANG YJ, CHEN MS, et al. Risk factors of survival after percutaneous radiofrequency ablation of hepatocellular carcinoma[J]. Surg Oncol, 2008, 17(1): 23-31. DOI: 10.1016/j.suronc.2007.08.002.
    [30]
    LIVRAGHI T, LAZZARONI S, MELONI F. Radiofrequency thermal ablation of hepatocellular carcinoma[J]. Eur J Ultrasound, 2001, 13(2): 159-166. DOI: 10.1016/s0929- 8266(01)00128-8.
    [31]
    HUANG J, YAN L, CHENG Z, et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria[J]. Ann Surg, 2010, 252(6): 903-912. DOI: 10.1097/SLA.0b013e3181efc656.
    [32]
    ZHONG JH, KE Y, GONG WF, et al. Hepatic resection associated with good survival for selected patients with intermediate and advanced-stage hepatocellular carcinoma[J]. Ann Surg, 2014, 260(2): 329-340. DOI: 10.1097/SLA.0000000000000236.
    [33]
    LEE S, KANG TW, SONG KD, et al. Effect of microvascular invasion risk on early recurrence of hepatocellular carcinoma after surgery and radiofrequency ablation[J]. Ann Surg, 2019, 273(3): 564-571. DOI: 10.1097/SLA.0000000000003268.
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