微波消融与手术切除治疗早期原发性肝癌临床疗效的Meta
分析
刘平;魏子白;于俊岩;田向阳
【期刊名称】《中华消化外科杂志》 【年(卷),期】2015(014)012
【摘要】目的 系统评价微波消融与手术切除治疗早期原发性肝癌的临床疗效.方法 以tumor、liver cancer、primary hepatic carcinoma、hepatocellular carcinoma、HCC, surgery、surgical、surgical resection、liver resection、hepatic resection,thermal ablation、percutaneous thermal ablation、microwave coagulation、microwave ablation,肝癌、原发性肝癌、肝细胞癌,手术、切除、手术切除、肝切除,微波、热消融、微波治疗、微波凝固、微波消融为检索词,检索Cochrane Library、Medline、PubMed、Web of Science、中国期刊全文数据库、万方数据库、维普数据库.检索时间为建库至2015年2月.纳入研究微波消融和手术切除治疗早期原发性肝癌临床疗效的相关对照试验,由2名研究者独立筛选文献和提取数据,并进行质量评价.行微波消融治疗患者为微波消融组,行手术切除治疗患者为手术组.计量资料采用标准均数差(SMD)及95％可信区间(95％CI)表示,计数资料采用优势比(OR)及95％ CI表示.采用I2对异质性进行分析.结果 最终纳入符合标准的相关研究共7篇,其中回顾性队列研究6篇,随机对照研究1篇;累计样本量993例,其中微波消融组648例,手术组345例.Meta分析结果显示:与手术组比较,微波消融组早期原发性肝癌患者术中出血量减少,术后住院时间缩短,差异均有统计学意义(SMD=-5.03,-1.74,95％ CI:-6.21～-3.85,-2.21 ～-1.28,P＜0.05).两组早期原发性肝癌患者术
后并发症发生率,1、3年总体生存率,1、3年无瘤生存率,1、2、3年肿瘤复发率比较,差异均无统计学意义(OR=1.57,1.10,1.20,0.77,1.23,1.32,2.31,1.39,95％CI:0.25～9.78,0.43 ～2.86,0.70 ～2.06,0.19 ～3.12,0.54 ～2.81,0.62 ～2.80,0.96 ～5.55,0.47 ～4.14,P＞0.05).结论 微波消融与手术切除治疗早期原发性肝癌同样安全可行、疗效可靠,且微波消融治疗术中出血量少、术后住院时间短.%Objective To evaluate the clinical efficacy of microwave ablation and surgical resection for the treatment of early primary hepatocellular carcinoma (HCC).Methods The Cochrane Library, Medline,PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang database, VIP database were searched with the key words of tumor, liver cancer, primary hepatic carcinoma, hepatocellular carcinoma, HCC,surgery, surgical, surgical resection, liver resection, hepatic resection, thermal ablation, percutaneous thermal ablation, microwave coagulation, microwave ablation, 肝癌, 原发性肝癌, 肝细胞癌, 手术, 切除, 手术切除, 肝切除, 微波, 热消融, 微波治疗, 微波凝固, 微波消融 between the database establishment and February 2015.Chinese and English literatures on microwave ablation and surgical resection for the treatment of early primary HCC were retrieved, and data were extracted and analyzed by 2 independent researchers.All the patients were divided into the microwave
ablation
group
and
the
surgical
resection
group.Measurement data were represented by the standardized mean difference (SMD) and 95％ confidence interval (CI), and count data were
represented by the odds ratio (OR) and 95％ CI.Heterogeneity of the publication was analyzed using the I2 test.Results Seven literature including 6 retrospective cohort studies and 1 randomized controlled trial were retrieved, and total sample size were 993 patients including 648 in the microwave ablation group and 345 in the surgical resection group.There were significant differences in the volume of blood loss and duration of postoperative hospital stay between the2groups (SMD=-5.03,-1.74, 95％ CI:-6.21-3.85,-2.21--1.28, P＜0.05).There were no significant difference in the incidence of postoperative complications, 1-, 3-year overall survival rates, 1-, 3-year tumor-free survival rates and 1-, 2-, 3-year recurrence rates between the 2 groups (OR =1.57, 1.10, 1.20,0.77, 1.23, 1.32, 2.31, 1.39, 95％CI: 0.25-9.78, 0.43-2.86, 0.70-2.06, 0.19-3.12,
0.54-2.81,0.62-2.80,
0.96-5.55,
0.47-4.14,
P
＞
0.05).Conclusions The safety, feasibility and clinical efficacy of microwave ablation for the treatment of early primary HCC is comparable to surgical resection, and microwave ablation has the advantages of lesser blood loss and shorter duration of hospital stay. 【总页数】7页(1031-1037)
【关键词】肝肿瘤,原发;微波消融;手术治疗;疗效;Meta分析 【作者】刘平;魏子白;于俊岩;田向阳
【作者单位】046000 山西长治市,长治医学院附属和平医院肿瘤科;046000 山西长治市,长治医学院附属和平医院肿瘤科;046000 山西长治市,长治医学院附属
微波消融与手术切除治疗早期原发性肝癌临床疗效的Meta分析
