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目的比较早期肝细胞癌(HCC)病人行手术切除(SR)和射频消融(RFA)的术后存活率和无瘤存活率。方法检索2004年1月至2014年10月Pub Med、MEDLINE、EMBASE、Cochrane图书馆数据库以及万方、CNKI数据库中收录的关于早期HCC行SR与RFA疗效比较的文献,根据纳入及排除标准选择文献,采用Stata11进行Meta分析,利用固定效应模型或随机效应模型计算术后1年、2年、3年、5年总体存活率及1年、2年、3年无瘤存活率的比值比(OR)及其95%可信区间(95%CI),应用漏斗图及Egger检验评估文献的发表偏倚。结果共纳入5篇随机对照研究和8篇回顾性研究。共统计12 580例早期HCC病人,其中SR组6237例,RFA组6343例。SR组和RFA组在1年总存活率上差异无统计学意义(P>0.05),SR组2、3、5年总存活率明显高于RFA组,差异有统计学意义(P<0.05);SR组1、2、3年无瘤存活率明显高于RFA组,差异有统计学意义(P<0.05)。结论 SR治疗早期HCC病人的术后总存活率和无瘤存活率均高于RFA治疗。
Objective To compare the postoperative survival and tumor-free survival of patients with early-stage hepatocellular carcinoma (HCC) undergoing surgical resection (SR) and radiofrequency ablation (RFA). METHODS: The literature of PubMed, MEDLINE, EMBASE, Cochrane Library Database and Wanfang and CNKI database for the comparison of the efficacy of SR and RFA in early HCC from January 2004 to October 2014 was searched, and the literature was selected according to inclusion and exclusion criteria , Stata11 was used for meta-analysis. The fixed-effect model or random-effect model was used to calculate the overall survival rates at 1 year, 2 years, 3 years and 5 years and the tumor-free survival rates at 1, 2 and 3 years ) And their 95% confidence intervals (95% CI). The funnel plot and Egger test were used to assess publication bias. Results A total of 5 randomized controlled trials and 8 retrospective studies were included. A total of 12 580 early HCC patients were enrolled, of whom 6237 were in the SR group and 6 343 in the RFA group. There was no significant difference in the 1-year overall survival between the SR group and the RFA group (P> 0.05). The overall survival rates at 2, 3 and 5 years in the SR group were significantly higher than those in the RFA group (P <0.05) The survival rate of one, two, three years in SR group was significantly higher than that in RFA group (P <0.05). Conclusion The overall survival rate and tumor-free survival rate of patients with early HCC after SR treatment are higher than that of RFA treatment.