消融治疗或小肝细胞癌手术的疗效和安全性比较：网络荟萃

StephenW

Comparative efficacy and safety between ablative therapies or surgery for small hepatocellular carcinoma: a network meta-analysis
Gui-Qi Zhu, Min Sun, Wei-Ting Liao, Wei-Hua Yu, Shao-Lai Zhou, Zheng-Jun Zhou, show all
Received 10 Dec 2017, Accepted 19 Jul 2018, Accepted author version posted online: 20 Jul 2018, Published online: 25 Jul 2018

    Download citation https://doi.org/10.1080/17474124.2018.1503531



ABSTRACT

Background: 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.

Methods: 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).

Results: 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.

Conclusions: 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.
KEYWORDS: Small hepatocellular carcinoma, network meta-analysis, randomized controlled trials, ablative therapy, liver resection
Additional information
Funding
This work was supported by the National Natural Science Fund of China [Grant numbers: No. 81672330; No. 81472218].

StephenW

消融治疗或小肝细胞癌手术的疗效和安全性比较：网络荟萃分析
朱桂琦，孙敏，廖伟婷，余伟华，周少来，周正军，全部展示
收到的2017年12月10日，接受2018年7月19日，接受作者版本在线发布：20 Jul 2018，发布在线：201 Jul 2018

    下载引文https://doi.org/10.1080/17474124.2018.1503531



抽象

背景：小肝细胞癌（SHCC）的主要治疗方法包括经皮乙醇注射（PEI），经皮醋酸注射（PAI），射频消融（RFA）或手术切除（SR）。我们的目的是比较这些有效性和安全性的疗法。

方法：从开始到2017年4月30日，对Cochrane图书馆，PubMed和Embase进行随机对照研究（RCT）搜索。比例死亡（PD），局部复发（LR）和不良事件（AE）的优势比（OR）。

结果：确定了14项随机对照试验。与SR相比，PEI（OR 2.79，CrI 1.25,6.45，p <0.01）显着增加PD的风险。类似地，PEI（OR 4.29，CrI 1.18,18.35，p <0.01）产生的LR多于SR。此外，SR显着地赋予比RFA更多的AE（OR 0.10; CrI 0.02,0.35，p <0.01），PEI（OR 0.06; CrI 0.01,0.31，p <0.01）。此外，RFA赋予HCC存活率，复发时间和新发展的最高疗效。

结论：SR优于PEI。虽然SR在临床疗效中获得了最高的累积排名概率，但它获得了患者的低利益风险比。 RFA优于其他消融疗法。对于直径> 2 cm或≤2cm的肿瘤，与其他SHCC疗法相比，SR具有非显着效果。
关键词：小肝细胞癌，网络荟萃分析，随机对照试验，消融治疗，肝切除术
附加信息
资金
这项工作得到了国家自然科学基金的支持[批准号：81672330; No. 81472218]。