Efficacy and safety of percutaneous radiofrequency ablation versus surgical resection for small hepatocellular carcinoma: a meta-analysis of 23 studies

The aim of our meta-analysis was to compare the efficacy and safety of radiofrequency ablation (RFA) versus surgical resection for patients with small hepatocellular carcinoma (SHCC). Randomized controlled trials (RCTs) or retrospective studies comparing the RFA with surgical resection for patients with SHCC published from 2004 to 2014 were selected from database of PubMed, EMBASE and Cochrane library. The outcomes including overall survival rate, recurrence-free survival rate, recurrence rate and complications (mortality rate and morbidity rate) were abstracted. Individual and pooled odds ratio with 95 % confidence interval of each outcome was analyzed. Three RCTs and twenty retrospective studies were included with a total of 15,482 patients. The 1-, 3- and 5-year overall survival rate and recurrence-free survival rate of surgical resection were significantly higher than RFA. The 2- and 3-year but not 1-year recurrence rate of RFA was significantly higher than surgical resection. The morbidity rate of complication in surgical resection group was higher than it in RFA group, but the mortality was not different between the two groups. Surgical resection led to a higher overall survival and recurrence-free survival rate in treating SHCC. However, RFA led to a lower morbidity rate of complication than surgical resection.