There are more literatures on the comparison of the outcome of small HCC between HR and RFA, but rare is about the comparison of the outcome between small solitary HCC and small oligonodular HCC meeting Milan criteria by HR or by RFA. Thus, the aim of the present study is to evaluate the outcome between small solitary HCC and small oligonodular HCC meeting Milan criteria treated by HR or by RFA. Total eighteen studies including 4,823 patients was included in this study. Among them LR group included 2,564 cases, and RFA group included 2,259 cases. We divided them into small solitary HCC sub-group and small oligonodular HCC sub-group and compared the survival difference between them. In the HR group, 1, 3, and 5 years OS of the small solitary HCC sub-group were 93.9%, 81.3%, and 72.0%, and the small oligonodular HCC sub-group were 83.3%, 70.4%, and 45.4%, respectively. For the DFS in the HR group, 1, 3, and 5 years of the small solitary HCC sub-group were 76.4%, 56.0%, and 44.0%, and 65.9%, 40.7%, and 11.1% of the small oligonodular HCC sub-group, respectively. In the RFA group, 1, 3, and 5 years OS of the small solitary HCC sub-group were 91.2%, 74.1%, and 54.5%, and the small oligonodular HCC sub-group were 82.0%, 55.4%, and 38.2%, respectively. For the DFS in the RFA group, 1, 3, and 5years of the small solitary HCC sub-group were 74.1%, 49.8%, and 22.1%, and 62.6% and 37.3%, 8.2% of the small oligonodular HCC sub-group, respectively.
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Recent advances in surgical techniques and perioperative management have been suggested to have improved survival. However, full agreement about the overall survival ofpatient with multinodular HCC is still not reached yet. The aim of this meta-analysis is to evaluate the survival of patients with multinodular HCC undergoing recent treatment modalities.Weperformed the systematic computerized search for eligible articles fromfour databases (PubMed, Embase, Google Scholar and Web of Science) published before February 2018. Summary effect size (ES) and 95% confidence interval (CI) were calculated with the random-effects model and fixed-effects model. A total of 25 studies with 18954 multinodular hepatocellular carcinoma patients were included. Overall survival was shorter inpatient having multinodular carcinoma undergoing different treatment modalities (ES 1.12, 95 % CI 1.02 to 1.21; p=0.000) which was statistically significant. Those undergoing hepatectomy was shorter (ES 1.49, 95% CI 1.33 to 1.64; p=0.304) which was not statistically significantand patients undergoing RFA was shorter (ES 1.61, 95% CI 1.28 to 1.94; p=0.020) which was statistically significant. Begg’s funnel plot showed no publication bias exists.Our meta-analysis result showed that the overall survival of patients with multinodular carcinoma is shorter.
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