Percutaneous Thermal Ablation Versus Liver Resection For Small Hepatocellular Carcinoma: A Systematic Review

Objective: To assess the clinical efficacy of percutaneous thermal ablation andliver resection for small hepatocellular carcinoma by means of systematic review.Methods: The randomized controlled trials concerning percutaneous thermal ablation andhepatectomy for treatment of small liver cancer were collected through literature retrievalfrom native and foreign databases. The quality of included studies was assessed accordingto the Cochrane systematic review method and statistical analysis of data was performedusing RevMan5.1.17software. Results: Four randomized controlled studies finally metthe inclusion criteria, with a total of683patients, of whom,340cases underwentpercutaneous thermal ablation and343cases underwent hepatectomy. The results ofmeta-analysis indicated that the1-and3-year overall survival rate,1-year tumor-freesurvival rate and1-year local tumor recurrence rate in the patients undergoing either of thetwo methods had no statistical difference (all P>0.05). The3-year of disease-free survivalrate and2-year of local tumor recurrence rate in patients undergoing liver resection werebetter than those in patients with percutaneous thermal ablation (both P<0.05). Theincidence of major complications in patients receiving percutaneous thermal ablation wassignificantly lower than that in patients undergoing liver resection (P<0.05), and patientsafter percutaneous thermal ablation showed shorter hospital stay, lower cost and bettersystemic conditions.Conclusion: For small liver cancer, percutaneous thermal ablationand liver resection present similar short-term efficacy, but the latter has better long-termresults.