1. Am J Gastroenterol. 2009 Feb;104(2):514-24. Epub 2009 Jan 13. Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. 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.it OBJECTIVES: Radiofrequency thermal ablation (RF) and percutaneous ethanol injection (PEI) have been employed in the treatment of small hepatocellular carcinoma (HCC) as curative treatments. The aim of the study was to review the available evidence comparing RF to PEI for small HCC. METHODS: Search strategy: Cochrane, MEDLINE, CANCERLIT, and ENBASE databases were used. Selection criteria: randomized clinical trials evaluating RF vs. PEI. Data were extracted from each randomized controlled trial (RCT). Primary outcomes were overall survival and local recurrence. Meta-analysis software was used and risk differences (RDs) and their 95% confidence intervals and Q-test for heterogeneity were calculated. RESULTS: Five RCTs were identified including 701 patients. The overall survival was significantly higher in patients treated with RF than in those treated with PEI (RD 0.116, 95% CI 0.173/0.060; heterogeneity not present). Local recurrence rate is significantly higher in patients treated with PEI than in those treated with RF. In the RF group the 1, 2, and 3 years cancer-free survival rates were significantly 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; heterogeneity P=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 with respect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3 cancer-free survival rates, and tumor response. RF shows a significantly smaller risk of local recurrence.

ORLANDO A, LEANDRO G, OLIVO M, ANDRIULLI A, COTTONE M (2009). Radiofrequency thermal ablation vs percutaneous ethanol injection for small hcc in cirrhosis:metanalysis of randomized controlled trials. THE AMERICAN JOURNAL OF GASTROENTEROLOGY, 104, 514-524 [10.1038/ajg.2008.80].

Radiofrequency thermal ablation vs percutaneous ethanol injection for small hcc in cirrhosis:metanalysis of randomized controlled trials

COTTONE, Mario
2009-01-01

Abstract

1. Am J Gastroenterol. 2009 Feb;104(2):514-24. Epub 2009 Jan 13. Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials. 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.it OBJECTIVES: Radiofrequency thermal ablation (RF) and percutaneous ethanol injection (PEI) have been employed in the treatment of small hepatocellular carcinoma (HCC) as curative treatments. The aim of the study was to review the available evidence comparing RF to PEI for small HCC. METHODS: Search strategy: Cochrane, MEDLINE, CANCERLIT, and ENBASE databases were used. Selection criteria: randomized clinical trials evaluating RF vs. PEI. Data were extracted from each randomized controlled trial (RCT). Primary outcomes were overall survival and local recurrence. Meta-analysis software was used and risk differences (RDs) and their 95% confidence intervals and Q-test for heterogeneity were calculated. RESULTS: Five RCTs were identified including 701 patients. The overall survival was significantly higher in patients treated with RF than in those treated with PEI (RD 0.116, 95% CI 0.173/0.060; heterogeneity not present). Local recurrence rate is significantly higher in patients treated with PEI than in those treated with RF. In the RF group the 1, 2, and 3 years cancer-free survival rates were significantly 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; heterogeneity P=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 with respect to overall survival, 1, 2, and 3 years survival rates, 1, 2, and 3 cancer-free survival rates, and tumor response. RF shows a significantly smaller risk of local recurrence.
2009
ORLANDO A, LEANDRO G, OLIVO M, ANDRIULLI A, COTTONE M (2009). Radiofrequency thermal ablation vs percutaneous ethanol injection for small hcc in cirrhosis:metanalysis of randomized controlled trials. THE AMERICAN JOURNAL OF GASTROENTEROLOGY, 104, 514-524 [10.1038/ajg.2008.80].
File in questo prodotto:
File Dimensione Formato  
termoablazione.pdf

Solo gestori archvio

Descrizione: articolo principale
Dimensione 153.91 kB
Formato Adobe PDF
153.91 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/47062
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 224
  • ???jsp.display-item.citation.isi??? 195
social impact