Comparison of radiofrequency ablation and surgical resection for hepatocellular carcinoma conforming to the Milan criteria: a meta-analysis.

BACKGROUND: The purpose of this study was to include all current randomized controlled trials to compare the clinical efficacy between radiofrequency ablation (RFA) and surgical resection (SR) in patients with hepatocellular carcinoma who meet the Milan criteria using meta-analysis techniques. METHODS: We conducted literature search of PubMed, Embase and Cochrane library clinical database for studies of RFA versus SR. Only randomized clinical trials were included. The odds ratios (OR) were pooled and calculated with 95% confidence intervals (CIs) for both fixed-effects and random-effects models. RESULTS: A total of 8 randomized controlled trials with 1177 patients were included in the present meta-analysis. There were no significantly difference between the patients underwent SR or RFA in terms of 1, 3 and 5 years' overall survival rate (OR 0.87, 95% CI 0.46-1.64; OR 0.84, 95% CI 0.57-1.24 and OR 1.03, 95% CI 0.61-1.73, respectively). And there were no significantly difference between the patients received SR and RFA in terms of 1 and 3 years' disease-free survival rate (OR 0.85, 95% CI 0.61-1.18 and OR 0.77, 95% CI 0.57-1.03). However, it is worth noting that RFA has advantages over SR in terms of treatment-related complications (OR 0.65, 95% CI 0.44-0.80; P < 0.05), post-operative mortality, length of stay and hospitalization costs. CONCLUSION: For patients with hepatocellular carcinoma who meet the Milan criteria, RFA exhibited similar clinical efficacy to SR.