机构：[a]Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China[b]State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China[c]Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China[d]Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院[e]Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China[f]Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
Major treatments for small hepatocellular carcinoma (SHCC) include percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI), radiofrequency ablation (RFA), or surgical resection (SR). We aimed to compare these therapies concerning with effectiveness and safety.
Cochrane Library, PubMed, and Embase were searched for randomized controlled studies (RCTs) from inception to 30 April 2017. Odds ratios (OR) for proportion dead (PD), local recurrence (LR) and adverse events (AEs).
Fourteen RCTs were identified. Compared with SR, PEI (OR 2.79, CrI 1.25, 6.45, p < 0.01) provided a significantly increased risk of PD. Similarly, PEI (OR 4.29, CrI 1.18, 18.35, p < 0.01) yielded more LR than SR. Also, SR significantly conferred more AEs than RFA (OR 0.10; CrI 0.02, 0.35, p < 0.01), PEI (OR 0.06; CrI 0.01, 0.31, p < 0.01). Besides, RFA conferred the highest efficacy for survival, time to recurrence, and new development of HCC.
SR was superior to PEI. Although SR achieved highest cumulative ranking probabilities in clinical efficacy, it obtained a low benefit-to-risk ratio for patients. RFA was superior to the other ablative therapies. For tumor sizes > 2 cm or ≤ 2 cm in diameter, SR conferred non-significant effects compared with other therapies for SHCC.
基金：
This work was supported by the National Natural Science Fund of China
[Grant numbers: No. 81672330; No. 81472218].
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类|3 区医学
小类|4 区胃肠肝病学
最新[2023]版：
大类|3 区医学
小类|4 区胃肠肝病学
第一作者：
第一作者机构：[a]Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China[b]State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
通讯作者：
通讯机构：[a]Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China[b]State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China[f]Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China[*1]Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China[*2]Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
推荐引用方式(GB/T 7714)：
Gui-Qi Zhu,Min Sun,Wei-Ting Liao,et al.Comparative efficacy and safety between ablative therapies or surgery for small hepatocellular carcinoma: a network meta-analysis.[J].Expert review of gastroenterology & hepatology.2018,12(9):935-945.doi:10.1080/17474124.2018.1503531.
APA：
Gui-Qi Zhu,Min Sun,Wei-Ting Liao,Wei-Hua Yu,Shao-Lai Zhou...&Zhi Dai.(2018).Comparative efficacy and safety between ablative therapies or surgery for small hepatocellular carcinoma: a network meta-analysis..Expert review of gastroenterology & hepatology,12,(9)
MLA：
Gui-Qi Zhu,et al."Comparative efficacy and safety between ablative therapies or surgery for small hepatocellular carcinoma: a network meta-analysis.".Expert review of gastroenterology & hepatology 12..9(2018):935-945
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