PMID- 30025486
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1747-4132 (Electronic)
IS  - 1747-4124 (Linking)
VI  - 12
IP  - 9
DP  - 2018 Sep
TI  - Comparative efficacy and safety between ablative therapies or surgery for small 
      hepatocellular carcinoma: a network meta-analysis.
PG  - 935-945
LID - 10.1080/17474124.2018.1503531 [doi]
AB  - BACKGROUND: Major treatments for small hepatocellular carcinoma (SHCC) include 
      percutaneous ethanol injection (PEI), percutaneous acetic acid injection (PAI), 
      radiofrequency ablation (RFA), or surgical resection (SR). We aimed to compare 
      these therapies concerning with effectiveness and safety. METHODS: Cochrane 
      Library, PubMed, and Embase were searched for randomized controlled studies 
      (RCTs) from inception to 30 April 2017. Odds ratios (OR) for proportion dead 
      (PD), local recurrence (LR) and adverse events (AEs). RESULTS: Fourteen RCTs were 
      identified. Compared with SR, PEI (OR 2.79, CrI 1.25, 6.45, p < 0.01) provided a 
      significantly increased risk of PD. Similarly, PEI (OR 4.29, CrI 1.18, 18.35, 
      p < 0.01) yielded more LR than SR. Also, SR significantly conferred more AEs than 
      RFA (OR 0.10; CrI 0.02, 0.35, p < 0.01), PEI (OR 0.06; CrI 0.01, 0.31, p < 0.01). 
      Besides, RFA conferred the highest efficacy for survival, time to recurrence, and 
      new development of HCC. CONCLUSIONS: SR was superior to PEI. Although SR achieved 
      highest cumulative ranking probabilities in clinical efficacy, it obtained a low 
      benefit-to-risk ratio for patients. RFA was superior to the other ablative 
      therapies. For tumor sizes > 2 cm or </= 2 cm in diameter, SR conferred 
      non-significant effects compared with other therapies for SHCC.
FAU - Zhu, Gui-Qi
AU  - Zhu GQ
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Sun, Min
AU  - Sun M
AD  - c Department of General Surgery, Taihe Hospital , Hubei University of Medicine , 
      Shiyan , China.
FAU - Liao, Wei-Ting
AU  - Liao WT
AD  - d Department of Medical Oncology, Cancer Center, West China Hospital , Sichuan 
      University , Chengdu , China.
FAU - Yu, Wei-Hua
AU  - Yu WH
AD  - e Department of General Surgery, Sir Run Run Shaw Hospital , Zhejiang University 
      , Hangzhou , China.
FAU - Zhou, Shao-Lai
AU  - Zhou SL
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Zhou, Zheng-Jun
AU  - Zhou ZJ
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Shi, Ying-Hong
AU  - Shi YH
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Fan, Jia
AU  - Fan J
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Zhou, Jian
AU  - Zhou J
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
FAU - Qiu, Li-Xin
AU  - Qiu LX
AD  - f Department of Medical Oncology , Fudan University Shanghai Cancer Center , 
      Shanghai , China.
FAU - Dai, Zhi
AU  - Dai Z
AD  - a Liver Cancer Institute, Zhongshan Hospital , Fudan University , Shanghai , 
      China.
AD  - b State Key Laboratory of Genetic Engineering , Fudan University , Shanghai , 
      China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20180725
PL  - England
TA  - Expert Rev Gastroenterol Hepatol
JT  - Expert review of gastroenterology & hepatology
JID - 101278199
SB  - IM
MH  - *Ablation Techniques/adverse effects/mortality
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Hepatocellular/mortality/pathology/*surgery
MH  - Disease Progression
MH  - Female
MH  - *Hepatectomy/adverse effects/mortality
MH  - Humans
MH  - Liver Neoplasms/mortality/pathology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Risk Factors
MH  - Treatment Outcome
MH  - *Tumor Burden
OTO - NOTNLM
OT  - Small hepatocellular carcinoma
OT  - ablative therapy
OT  - liver resection
OT  - network meta-analysis
OT  - randomized controlled trials
EDAT- 2018/07/22 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/07/21 06:00
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/07/21 06:00 [entrez]
AID - 10.1080/17474124.2018.1503531 [doi]
PST - ppublish
SO  - Expert Rev Gastroenterol Hepatol. 2018 Sep;12(9):935-945. doi: 
      10.1080/17474124.2018.1503531. Epub 2018 Jul 25.