According to the American Association for the Study of Liver Diseases guidelines, percutaneous ethanol injection is a safe and highly effective treatment for small hepatocellular carcinomas.
It should be the standard against which any new therapy is compared.
Dr Yun Ku Cho and colleagues from Korea identified survival benefit of any percutaneous ablation therapy as compared with percutaneous ethanol injection in the treatment of patients with unresectable hepatocellular carcinomas.
The secondary endpoints were initial tumor response, local tumor progression, and complications.
Randomized controlled trials that compared pecutaneous ablative therapies with percutaneous ethanol injection were included.
The team used MEDLINE, the Cochrane Library, CANCERLIT, and manual searches from 1978 to 2008.
To control the potential heterogeneity, the random effects model of DerSimonian and Laird was used for a meta-analysis.
|Radiofrequency ablation demonstrated improved 3-year survival |
Egger's test was performed to test a potential publication bias.
The researchers identified 7 randomized controlled trials.
However, only 4 randomized controlled trials involving 652 patients that compared radiofrequency ablation with percutaneous ethanol injection met the inclusion criteria to perform a meta-analysis assessing 3-year survival.
The researchers found a significant improvement in 3-year survival favoring radiofrequency ablation over percutaneous ethanol injection.
Heterogeneity among the 4 trials was not significant.
The team found egger's test revealed that the publication bias was not significant.
However, the number of patients included in the analysis was insufficient for a robust meta-analysis of initial tumor response.
The definition of local tumor progression or major complication was not unified among the trials included in the meta-analysis.
Dr Cho’s team concluded, “Radiofrequency ablation demonstrated significantly improved 3-year survival status for patients with hepatocellular carcinomas, when compared to percutaneous ethanol injection .”