目的：比较射频消融术（RFA）与外科手术再切除（SRR）治疗符合米兰标准的术后复发性肝癌的有效性与安全性。 方法：检索国内外数据库，收集2000年1月—2017年1月间发表的对比RFA和SRR治疗符合米兰标准的术后复发性肝癌的临床对照试验，用RevMan 5.3软件对符合标准的临床试验数据进行分析。 结果：纳入11个临床试验共1 079例患者，其中RFA治疗患者560例（RFA组），SRR治疗患者519例（SRR组）。Meta分析结果显示，两组术后1、3、5年生存率差异均无统计学意义（均P>0.05），但RFA组术后并发症发生率明显低于SRR组（OR=0.25，95% CI=0.14~0.44，P<0.00001）、住院时间明显短于SRR组（OR=-6.57，95% CI=-7.74~-4.09，P<0.00001），而SRR组3年无瘤生存率明显优于RFA组（OR=0.60，95% CI=0.42~0.86，P=0.006）。 结论：两种方式治疗符合米兰标准的术后复发性肝癌的临床疗效无显著区别，但RFA具有微创、可重复操作、安全性高等优势。
Radiofrequency ablation versus surgical re-resection for postoperative recurrent hepatocellular carcinoma within the Milan criteria: a Meta-analysis
Objective: To compare the efficacy and safety of radiofrequency ablation (RFA) and surgical re-resection (SRR) in treatment of recurrent hepatocellular carcinoma (HCC) within the Milan Criteria. Methods: The clinical controlled studies comparing RFA and SRR in treatment of postoperative recurrent HCC published between January 2000 and January 2017 were collected by searching from national and international databases. The data from eligible studies were analyzed by Revman5.3 software. Results: Eleven clinical studies were included involving 1 079 patients, of whom, 560 cases underwent RFA (RFA group) and 519 underwent SRR (SRR group). The results of Meta-analysis showed that there was no significant difference in postoperative 1-, 3- and 5-year survival rates between the two groups (all P>0.05), but the incidence of postoperative complications was decreased (OR=0.25, 95% CI=0.14–0.44, P<0.00001) and the length of hospital stay was shortened (OR=–6.57, 95% CI=–7.74--4.09, P<0.00001) in RFA group compared with SRR group, while the 3-year recurrence-free survival in SRR group was superior to that in RFA group (OR=0.60, 95% CI=0.42–0.86, P=0.006). Conclusion: There is no significant efficacy difference between the two methods in treatment of postoperative recurrent HCC within the Milan Criteria, while RFA possesses the advantages of minimal invasiveness, repeatable operation and high safety level.