Safety And Efficacy Of Radiofrequency Ablation For Small Hepatocellular Carcinoma

Objective: To observe the clinical efficacy and complications of radiofrequency ablation(RFA)in the treatment of small hepatocellular carcinoma(SHCC),and to systematically evaluate the current application of RFA in SHCC,so as to clarify its value in the treatment of SHCC.Methods:First part:Sixty patients with primary small hepatocellular carcinoma in Hunan Hospital from September 2015 to January 2017 were collected.They were randomly divided into radiofrequency ablation group with twenty-five patients and operation group with thirty-five patients.The Short-term efficacy,long-term efficacy and incidence of complications were compared between the two groups.Second part:The controlled trial of radiofrequency ablation and surgical resection for small hepatocellular carcinoma published from January 2012 to December 2017 were collected.RevMan 5.2 software was used to conduct a meta-analysis of the included literature.The 1-year and 3-year survival rates and the incidence of postoperative complications were compared.Results:1.The serum AFP level of radiofrequency ablation group and operation group were(211.08±32.37)and(209.57±33.05).There was no significant difference between the two groups before treatment(P>0.05).After treatment,the level of serum AFP in the two groups was significantly lower than that before treatment(P<0.05),but there was no statistical difference between the two groups(P>0.05).2.The short-term effective rate of operation group was 97.14%,and that of radiofrequency ablation group was 92%(P>0.05).3.The local recurrence rate,the distant recurrence rate,the total recurrence rate of operation group were 20%,5.71%,25.71%.The local recurrence rate,the distant recurrence rate,the total recurrence rate of radiofrequency ablation group were 24%,8%,32%.There was no significant difference between the two groups(P>0.05).4.The mean follow-up time was(17.53±2.92)months.The 1-year and 2-year survival rates were 85.71% and 80% in the operation group.The progressive lifetime and survival time were(10.99±4.05)and(21.26±4.94)monthsin the operation group.The 1-year and 2-year survival rates were 84% and 76% in the radiofrequency ablation group,and progressive lifetime and survival time were(11.02±4.88)and(20.93±5.14)month in the radiofrequency ablation group.There was no significant difference between the two groups(P>0.05).5.The scores of SF-36 scale in radiofrequency ablation group were significantly higher than those in operation group(P<0.05).6.The operation time,bleeding volume and hospitalization time of the radiofrequency ablation group were significantly lower than those of the operation group(P<0.05).7.Nine literatures for meta-analysis showed that the 1-year survival rates of radiofrequency ablation and surgical resection were OR: 0.92,95%CI(0.62,1.37),P=0.69.8.Nine literatures for meta-analysis showed that the 3-year survival rates of radiofrequency ablation and surgical resection were OR: 0.84,95%CI(0.54,1.32),P=0.46.9Nine literatures for meta-analysis showed that the incidence of complications of radiofrequency ablation and surgical resection was OR: 0.56,95%CI(0.41,0.76),P=0.0002.Conclusion:1.Radiofrequency ablation for small hepatocellular carcinoma has the same short-term and long-term effects as surgical resection.2.Radiofrequency ablation for small hepatocellular carcinoma has lower incidence of complications and higher safety than surgical resection on the premise of ensuring its effectiveness.3.The study has high reliability and can be used as a reference for the choice of therapeutic methods for small hepatocellular carcinoma.