TY - JOUR
T1 - Radiofrequency thermal ablation vs percutaneous ethanol injection for small hcc in cirrhosis:metanalysis of randomized controlled trials
AU - Cottone, Mario
AU - Cottone, Mario
AU - Olivo, Mirko
AU - Andriulli, Angelo
AU - Orlando, Ambrogio
AU - Leandro, Gioacchino
PY - 2009
Y1 - 2009
N2 - 1. Am J Gastroenterol. 2009 Feb;104(2):514-24. Epub 2009 Jan 13.Radiofrequency thermal ablation vs. percutaneous ethanol injection for smallhepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlledtrials.Orlando A, Leandro G, Olivo M, Andriulli A, Cottone M.Department of Medicine, Pneumology and Nutrition Clinic, V. Cervello Hospital,University of Palermo, Piazza Mameli 1, Palermo, Italy. ambrogiorlando@tiscali.itOBJECTIVES: Radiofrequency thermal ablation (RF) and percutaneous ethanolinjection (PEI) have been employed in the treatment of small hepatocellularcarcinoma (HCC) as curative treatments. The aim of the study was to review theavailable evidence comparing RF to PEI for small HCC.METHODS: Search strategy: Cochrane, MEDLINE, CANCERLIT, and ENBASE databases wereused. Selection criteria: randomized clinical trials evaluating RF vs. PEI. Data were extracted from each randomized controlled trial (RCT). Primary outcomes wereoverall survival and local recurrence. Meta-analysis software was used and riskdifferences (RDs) and their 95% confidence intervals and Q-test for heterogeneitywere calculated.RESULTS: Five RCTs were identified including 701 patients. The overall survivalwas significantly higher in patients treated with RF than in those treated withPEI (RD 0.116, 95% CI 0.173/0.060; heterogeneity not present). Local recurrencerate is significantly higher in patients treated with PEI than in those treatedwith RF. In the RF group the 1, 2, and 3 years cancer-free survival rates weresignificantly better than in the PEI-treated patients (respectively: RD 0.098-95%CI 0.006/0.189; heterogeneity P=0.57; RD 0.187, 95% CI 0.082/0.293; heterogeneityP=0.98; RD 0.210, 95% CI 0.095/0.325; heterogeneity P = 0.78). A small number of adverse events were reported in the two treatments.CONCLUSIONS: RF ablation is superior to PEI in the treatment of small HCC withrespect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3cancer-free survival rates, and tumor response. RF shows a significantly smaller risk of local recurrence.
AB - 1. Am J Gastroenterol. 2009 Feb;104(2):514-24. Epub 2009 Jan 13.Radiofrequency thermal ablation vs. percutaneous ethanol injection for smallhepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlledtrials.Orlando A, Leandro G, Olivo M, Andriulli A, Cottone M.Department of Medicine, Pneumology and Nutrition Clinic, V. Cervello Hospital,University of Palermo, Piazza Mameli 1, Palermo, Italy. ambrogiorlando@tiscali.itOBJECTIVES: Radiofrequency thermal ablation (RF) and percutaneous ethanolinjection (PEI) have been employed in the treatment of small hepatocellularcarcinoma (HCC) as curative treatments. The aim of the study was to review theavailable evidence comparing RF to PEI for small HCC.METHODS: Search strategy: Cochrane, MEDLINE, CANCERLIT, and ENBASE databases wereused. Selection criteria: randomized clinical trials evaluating RF vs. PEI. Data were extracted from each randomized controlled trial (RCT). Primary outcomes wereoverall survival and local recurrence. Meta-analysis software was used and riskdifferences (RDs) and their 95% confidence intervals and Q-test for heterogeneitywere calculated.RESULTS: Five RCTs were identified including 701 patients. The overall survivalwas significantly higher in patients treated with RF than in those treated withPEI (RD 0.116, 95% CI 0.173/0.060; heterogeneity not present). Local recurrencerate is significantly higher in patients treated with PEI than in those treatedwith RF. In the RF group the 1, 2, and 3 years cancer-free survival rates weresignificantly better than in the PEI-treated patients (respectively: RD 0.098-95%CI 0.006/0.189; heterogeneity P=0.57; RD 0.187, 95% CI 0.082/0.293; heterogeneityP=0.98; RD 0.210, 95% CI 0.095/0.325; heterogeneity P = 0.78). A small number of adverse events were reported in the two treatments.CONCLUSIONS: RF ablation is superior to PEI in the treatment of small HCC withrespect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3cancer-free survival rates, and tumor response. RF shows a significantly smaller risk of local recurrence.
KW - Radiofrequency thermal ablation
KW - meta-analysis
KW - percutaneous ethanol injecction
KW - small hepatocellular carcinoma
KW - Radiofrequency thermal ablation
KW - meta-analysis
KW - percutaneous ethanol injecction
KW - small hepatocellular carcinoma
UR - http://hdl.handle.net/10447/47062
M3 - Article
VL - 104
SP - 514
EP - 524
JO - THE AMERICAN JOURNAL OF GASTROENTEROLOGY
JF - THE AMERICAN JOURNAL OF GASTROENTEROLOGY
SN - 0002-9270
ER -