Journal of Cancer Research and Clinical Oncology

, Volume 139, Issue 12, pp 2021–2033 | Cite as

Percutaneous ablation therapy versus surgical resection in the treatment for early-stage hepatocellular carcinoma: a meta-analysis of 21,494 patients

  • Jia-yan Ni
  • Lin-feng Xu
  • Hong-liang Sun
  • Jing-xing Zhou
  • Yao-ting Chen
  • Jiang-hong Luo
Original Paper



To compare comprehensively the benefits of radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) with those of surgical resection (SR) in early-stage hepatocellular carcinoma (HCC).


The potentially relevant studies comparing the efficacy and safety of RFA and/or PEI with those of SR were searched using the databases such as PubMed, MEDLINE, Embase and Chinese databases (CNKI and Wanfang data). Overall survival rate, recurrence-free survival rate and complications were compared and analyzed. Pooled odds ratios with 95 % confidence intervals (95 % CIs) were calculated using either the fixed-effects model or random-effects model. All statistic analyses were conducted using the Review Manager (version 5.1.) from the Cochrane Collaboration.


Our analysis showed that the overall survival rate in patients treated with SR was significantly higher than that of percutaneous ablation therapy (PAT) [SR vs. PAT: 95 % confidence interval (95 % CI)2-year 0.46–0.89, P = 0.009; 95 % CI3-year 0.57–0.83, P < 0.0001; 95 % CI5-year 0.45–0.46, P < 0.0001]. SR was associated with significantly higher recurrence-free survival rate compared with PAT (SR vs. PAT: 95 % CI1-year 0.51–0.90, P = 0.008; 95 % CI2-year 0.41–0.78, P = 0.0004; 95 % CI3-year 0.38–0.77, P = 0.0006; 95 % CI5-year 0.33–0.61, P < 0.0001). SR resulted in longer survival than PAT in HCCs no larger than 3 cm. PAT was associated with less complications compared with SR (PAT vs. SR: 95 % CI 0.14–0.76, P = 0.01).


Although SR was associated with more complications, SR was superior to RFA and PEI for treatment of patients with early-stage HCC.


Radiofrequency ablation Percutaneous ethanol injection Surgical resection Hepatocellular carcinoma Meta-analysis 


Conflict of interest

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jia-yan Ni
    • 1
  • Lin-feng Xu
    • 1
  • Hong-liang Sun
    • 1
  • Jing-xing Zhou
    • 1
  • Yao-ting Chen
    • 1
  • Jiang-hong Luo
    • 1
  1. 1.Department of Interventional Radiology, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouPeople’s Republic of China

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