Repeat resection versus percutaneous ablation for recurrent hepatocellular carcinoma: a meta-analysis

Introduction: Both repeat resection (RR) and percutaneous ablation (PA) have been used for treating recurrent hepatocellular carcinoma (rHCC). Each method has its advantages and disadvantages. Aim: To compare the safety and effectiveness between RR and PA in patients with rHCC. Material and methods: Relevant articles published in the PubMed, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases published as of April 2022 were identified. Primary endpoints for this meta-analysis included patient overall survival (OS) and disease-free survival (DFS), whereas secondary endpoints included rates of repeat recurrence, complications, and the duration of hospitalization. Results: This meta-analysis included a total of 6 relevant studies. Pooled repeat recurrence rates were comparable between the PA and RR groups (p = 0.09), although the pooled 5-year DFS rate (p = 0.01), DFS duration (p = 0.02), and 3-year OS rate (p = 0.04) in the RR group were considerably higher than in the PA group. Pooled rates of both Grade 1/2 (p = 0.04) and Grade 3/4 (p = 0.001) complications, however, were significantly lower for patients who underwent PA as compared to patients who underwent RR. PA was associated with a significantly shorter hospitalization duration relative to RR in this patient cohort (p = 0.0002). Conclusions: According to the obtained findings, RR may be associated with better long-term disease control in rHCC patients than PA, whereas PA is associated with a better safety profile and a shorter duration of hospitalization.