Background and aims So far, no randomized trial or meta-analysis has been conducted on overall survival (OS) and recurrence-free survival (RFS) factors in patients treated with radiofrequency ablation (RFA) alone. The purpose of this meta-analysis was to evaluate prognostic factors of OS and RFS in patients treated with RFA. Methods A primary analysis was planned to evaluate the clinical prognostic factor of OS. RFS was the secondary aim. Thirty-four studies published from 2003 to 2017 were analyzed. They included 11,216 hepatocellular carcinoma patients. Results The results showed that Child–Pugh B vs Child–Pugh A (HR =2.32; 95% CI: 2.201–2.69; P<0.0001) and albumin–bilirubin score 1 vs 0 (HR =2.69; 95% CI: 2.10–3.44; P<0.0001) were predictive of poor OS. Tumor size as a continuous variable was not predictive of OS, although it was predictive of OS when we considered the size as a cutoff value (.2 cm vs <2 cm: HR =1.41; 95% CI: 1.23–1.61; P<0.0001; >3 cm vs <3 cm: HR =1.43; 95% CI: 1.17–1.74; P<0.0001) and in presence of >1 nodule (HR =1.59; 95% CI: 1.46–1.74; P<0.0001). Alpha-fetoprotein >20 ng/mL (HR =1.46; 95% CI: 1.25–1.70; P<0.0001) was the only predictive factor of poor prognosis. Conclusion Our meta-analysis highlighted that the maximum benefit of RFA in terms of OS and RFS is reached in the presence of Child–Pugh A, albumin–bilirubin score 1, single-nodule tumor sized <2 cm, and alpha-fetoprotein <20 ng/mL.
|Data di pubblicazione:||2018|
|Titolo:||Radiofrequency Ablation of hepatocellular carcinoma: a meta-analysis of overall survival and recurrence-free survival|
|Autore/i:||Casadei Gardini, Andrea; Marisi, Giorgia; Canale, Matteo; Foschi, Francesco Giuseppe; Donati, Gabriele; Ercolani, Giorgio; Valgiusti, Martina; Passardi, Alessandro; Frassineti, Giovanni Luca; Scarpi, Emanuela|
|Digital Object Identifier (DOI):||10.2147/OTT.S170836|
|Codice identificativo ISI:||WOS:000446740900002|
|Codice identificativo Scopus:||2-s2.0-85057963526|
|Citazione:||Radiofrequency Ablation of hepatocellular carcinoma: a meta-analysis of overall survival and recurrence-free survival / Casadei Gardini, Andrea; Marisi, Giorgia; Canale, Matteo; Foschi, Francesco Giuseppe; Donati, Gabriele; Ercolani, Giorgio; Valgiusti, Martina; Passardi, Alessandro; Frassineti, Giovanni Luca; Scarpi, Emanuela. - In: ONCOTARGETS AND THERAPY. - ISSN 1178-6930. - Volume 11(2018), pp. 6555-6567.|
|Tipologia||Articolo su rivista|
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