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Abstract：
The outcomes of cirrhotic patients with hepatocellular carcinoma (HCC) after thermal ablation (TA) versus liver resection (LR) are debated. We aimed to compare the overall survival (OS), disease-free survival (DFS), and operative outcomes after TA and LR for HCC in patients with cirrhosis. Until November 15, 2022, we searched PubMed, Embase, and Cochrane databases by using Medical Subject Heading terms and other terms, and used the Newcastle-Ottawa literature evaluation scale to assess the quality of selected studies. OS, DFS, and operative outcomes were extracted and analyzed. The meta-analysis showed that 5 propensity-score matched (PSM) studies including 933 patients (463 TA vs. 470 LR) were included. After analysis, TA and LR had similar results at 1-year OS (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.01-2.78; P = 0.05) and 3-year OS (OR 0.76; 95% CI 0.56-1.04; P = 0.08), whereas LR increased 5-years OS (OR 0.37; 95% CI 0.18-0.74; P = 0.005). In addition to the DFS, the 1-year DFS was significantly higher in patients with LR. However, there were no obvious differences in 3-year and 5-year DFS when comparing TA and LR. The length of operative time and hospital stay were longer in the LR group. Besides, the LR group had significantly higher rate of perioperative blood transfusions and major complications. Our research proved that LR took advantage of OS and DFS for HCC patients with cirrhosis. Additional well-designed randomized controlled trials are needed.
摘要：
热消融（TA）与肝切除术（LR）后肝硬化患者肝细胞癌（HCC）的结果存在争议。我们的目的是比较总生存期(OS)，无病生存率（DFS），肝硬化患者TA和LR治疗肝癌后的手术结果。直到2022年11月15日，我们搜索了PubMed，Embase,和Cochrane数据库使用医学主题标题术语和其他术语，并使用Newcastle-Ottawa文献评价量表对入选研究的质量进行评价。操作系统,DFS,提取并分析手术结果。荟萃分析显示，5项倾向评分匹配(PSM)研究包括933例患者(463TAvs.包括470LR）。经过分析,TA和LR在1年OS（比值比[OR]1.68;95％置信区间[CI]1.01-2.78;P=0.05）和3年OS（OR0.76;95％CI0.56-1.04;P=0.08）下的结果相似，而LR增加5年OS(OR0.37;95%CI0.18-0.74;P=0.005)。除了DFS，LR患者的1年DFS显著较高.然而,比较TA和LR时，3年和5年DFS没有明显差异。LR组的手术时间和住院时间更长。此外,LR组患者围手术期输血率和主要并发症发生率明显较高。我们的研究证明，LR利用OS和DFS的肝癌肝硬化患者。需要其他精心设计的随机对照试验。
