Long-Term Efficacy of Laparoscopic Radiofrequency Ablation in Early Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

Abstract

Objective: The aim of this study was to investigate the long-term efficacy of laparoscopic radiofrequency ablation (LRFA) in early hepatocellular carcinoma (HCC) compared with other surgical procedures. Methods: A literature search of Cochrane library, PubMed, and Embase through October 2018 was conducted by two investigators (J.-F.G. and F.Y.) independently. The quality of included studies was estimated by the Newcastle-Ottawa Scale. Review Manager 5.3 software was used for meta-analysis, and either fixed- or random-effects model was used according to the heterogeneity of included studies. The chi-square test was used for heterogeneity analysis of included studies, and subgroup analysis was conducted to estimate the heterogeneity between each study and also to estimate the efficacy of different studies. Results: A total of 11 studies involving 1691 patients were included in this analysis. Patients undergoing hepatic resection (HR) had higher 3-, 5-year overall survival rate, 3-year disease-free survival rate, and lower local recurrence rate than those undergoing LRFA. However, patients undergoing LRFA had higher 3-, 5-year overall survival rate than those undergoing other minimally invasive ablation, although there was no statistical difference in local recurrence rate or disease-free survival rate. Conclusion: HR is still an ideal choice for early HCC. If minimally invasive ablation is an alternative treatment, LRFA will be better than other minimally invasive options.