Comparison of hepatic resection and radiofrequency ablation for small hepatocellular carcinoma: A meta-analysis of 16,103 patients

Abstract

We performed a meta-analysis to evaluate the therapeutic effects of radiofrequency ablation (RFA) and surgical hepatic resection (HR) in the treatment of small hepatocellular carcinoma (HCC). Thirty-one studies were included in the analysis. A total of 16,103 patients were involved: 8,252 treated with RFA and 7,851 with HR. Compared to the RFA group, the 3, 5-year overall and disease-free survival rates in the HR group were significantly higher. On the other hand, complications were significantly fewer and hospital-stay was significantly shorter in the RFA group than in the HR group. In subgroup analyses, the overall and disease-free survival in the HR group were also significantly higher than those in the RFA group for HCCs ≤cm, whereas there were no significant differences between the two groups for HCCs ≤cm. Our analysis showed that although HR was associated with higher complication rate and longer hospital-stay, HR is proposed as the first-line treatment rather than RFA for patients with HCCs larger than 2cm. For patients with HCCs of 2cm or less, RFA may be an alternative to HR because of their comparable long-term efficacy.