A Systematic Assessment of the Quality of Systematic Reviews/Meta-Analyses in Radiofrequency Ablation versus Hepatic Resection for Small Hepatocellular Carcinoma<sup>△</sup>_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGYing-qiang ^1,2 , LUOQian-qian ³ ,  LIYou-ping ¹ , DENGShao-lin ^4,5 , LIXiang-lian ¹ , WEIShi-you ⁴

1. Chinese Evidence-Based Centre, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Medical Administration, 363^th Hospital, Chengdu 610041, China;
3. National Center for Safety Evaluation of Drugs(Chengdu), West China Hospital, Chengdu 610041, China;
4. West China Medical School, West China Hospital, Sichuan University, Chengdu 610041, China;
5. West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIYou-ping, Email: yzmylab@hotmail.com

Keywords：

Radiofrequency ablation; Hepatic resection; Hepatocellular carcinoma; Quality assessment; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.20140095

Video：

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Objective To evaluate the methodological quality and impacts on outcomes for systematic reviews (SRs) of radiofrequency ablation (RFA) versus hepatic resection (HR) for early hepatocellular carcinoma (HCC). Methods We comprehensively searched six databases and five official websites for health technology assessment (HTA), to collect HTAs, SRs, or meta-analyses from inception to Nov. 11^th, 2012. The Overview Quality Assessment Questionnaire (OQAQ) was applied for quality assessment of included studies, the tools recommended by the Cochrane Collaboration was applied for quality assessment for randomized controlled trials (RCTs), and the modified MINORS score was applied to assess non-randomized controlled trials (NRCTs). The odds ratios (ORs) and 95% confidence intervals (CIs) were integrated using Stata 10.0 software. Results One HTA, 3 SRs and 15 meta-analyses were included in total. The mean OQAQ score was 3.3 with 95%CI 2.6 to 4.1. Only five (26.3%) SRs were assessed as good quality. Seven studies misused statistical models, and 3 of them changed outcome direction after modification. Five studies (5/19) included retrospective controlled studies as RCTs. A total of 39 primary studies referenced by SRs were included, of which, 3 RCTs were levelled grade B, 35 NRCTs were of moderate quality, with an estimated mean MINORS score of 15.0 (totally, scored 18) with 95%CI 14.6 to 15.4, and only 13 studies (37.1%) scored more than 16. Seventeen primary studies (43.6%) did not meet inclusion criteria of the SRs, of which, 9 (23.1%) studies were mixed with other effective interventions in both groups (TACE, PEI, etc.). Four studies included patients with non-primary HCC. Conclusion Currently, the overall quality of HTAs, SRs and meta-analyses about comparing the effects between RFA and HR for early HCC is fairly poor (high heterogeneity exists, and the evidence level is low. Physicians should apply the evidence with caution in clinical practice.

Citation： WANGYing-qiang, LUOQian-qian, LIYou-ping, DENGShao-lin, LIXiang-lian, WEIShi-you. A Systematic Assessment of the Quality of Systematic Reviews/Meta-Analyses in Radiofrequency Ablation versus Hepatic Resection for Small Hepatocellular Carcinoma^△. Chinese Journal of Evidence-Based Medicine, 2014, 14(5): 561-574. doi: 10.7507/1672-2531.20140095 Copy

1.	Llovet JM, Lencioni R, di Bisceglie AM, et al. EASL-EORTC Clinical Practice Guidelines:Management of hepatocellular carcinoma. J Hepatol, 2012, 56(4):908-943.
2.	Soerjomataram I, Lortet-Tieulent J, Parkin DM, et al. Global burden of cancer in 2008:a systematic analysis of disability-adjusted lifeyears in 12 world regions. Lancet, 2012, 380(9856):1840-1850.
3.	Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwise:IARC cancerBase No.10[Internet]. 2010, 24. Available at: http://globocan.iarc.fr.[Accessed11, 2012].
4.	Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917.
5.	Bruix J, Sherman M. Management of hepatocellular carcinoma:an update. Hepatology, 2011, 53(3):1020-1022.
6.	Kobayashi M, Ikeda K, Kawamura Y, et al. High serum des-gammacarboxy prothrombin level predicts poor prognosis after radiofrequency ablation of hepatocellular carcinoma. Cancer, 2009, 115(3):571-580.
7.	Ye SL. Expert consensus on standardization of the management of primary liver cancer. Zhonghua Gan Zang Bing Za Zhi, 2009, 17(6): 403-410.
8.	Crocetti L, de Baere T, Lencioni R. Quality Improvement Guidelines for Radiofrequency Ablation of Liver Tumours. Cardiovasc Intervent Radiol, 2010, 33(1):11-17.
9.	Guglielmi A, Ruzzenente A, Valdegamberi A, et al. Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis. J Gastrointest Surg, 2008, 12(1):192-198.
10.	Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol, 2012, 57(4):794-802.
11.	Wang JH, Wang CC, Hung CH, et al. Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma. J Hepatol, 2012, 56(2):412-418.
12.	Peng ZW, Lin XJ, Zhang YJ, et al. Radiofrequency ablation versus hepatic resection for the treatment of hepatocellular carcinomas 2cm or smaller:a retrospective comparative study. Radiology, 2012, 262(3):1022-1033.
13.	Xu G, Qi FZ, Zhang JH, et al. Meta-analysis of surgical resection and radiofrequency ablation for early hepatocellular carcinoma. World J Surg Oncol, 2012, 10(1):163.
14.	Liu Z, Zhou Y, Zhang P, et al. Meta-analysis of the therapeutic effect of hepatectomy versus radiofrequency ablation for the treatment of hepatocellular carcinoma (Structured abstract). Surg Laparosc Endosc Percutan Tech, 2010(3):130-140.
15.	Liu JG, Wang YJ, Du Z. Radiofrequency ablation in the treatment of small hepatocellular carcinoma:a meta analysis. World J Gastroenterol, 2010, 16(27):3450-3456.
16.	孙彪, 郑传胜, 冯敢生, 等.射频消融对比手术切除治疗小肝癌的Meta分析.世界华人消化杂志, 2011, 19(31):3255-3263.
17.	Li L, Zhang JL, Liu XH, et al. Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: A meta-analysis. J Gastroenterol Hepatol, 2012, 27(1):51-58.
18.	Xie XQ, Dendukuri N, McGregor M. Percutaneous radiofrequency ablation for the treatment of early stage hepatocellular carcinoma: A health technology assessment. Int J Technol Assess Health Care, 2010, 26(4):390-397.
19.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. PLoS Med, 2009, 6(7):e1000097.
20.	Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44(1):91-98.
21.	Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44(11):1271-1278.
22.	Slim K, Nini E, Forestier D, et al. Methodological index for nonrandomized studies (minors):development and validation of a new instrument. ANZ J Surg, 2003, 73(9):712-716.
23.	Higgins JP, Green S. Conchrane Handbook for Systematic Reviews of Interventions 5.1.0[updated March 2011]. The Cochrane Collaboration2011.
24.	Tiong L, Maddern GJ. Systematic review and meta-analysis of survival and disease recurrence after radiofrequency ablation for hepatocellular carcinoma. Br J Surg, 2011, 98(9):1210-1224.
25.	Minami Y, Kudo M. Radiofrequency ablation of hepatocellular carcinoma:a literature review. Int J Hepatol, 2011, 2011:104685.
26.	Lau WY, Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma:a systematic review. Ann Surg, 2009, 249(1):20-25.
27.	黄子明, 张洪义, 李志杰, 等.射频消融与手术切除治疗小肝癌的Meta分析.中国现代普通外科进展, 2012, 15(03):211-215.
28.	游伟, 李相成.小肝癌射频消融与手术切除疗效的Meta分析.南京医科大学学报(自然科学版), 2012, 32(08):1179-1184.
29.	周大臣, 耿小平, 朱立新, 等.经皮射频消融与肝切除治疗小肝癌的疗效比较meta分析.中华外科杂志, 2011, 49(12):1132-1136.
30.	王振, 钱叶本.小肝癌射频消融术与手术切除术疗效的Meta分析.肝胆外科杂志, 2011, 19(01):23-27.
31.	Gravante G, Overton J, Sorge R, et al. Radiofrequency ablation versus resection for liver tumours:an evidence-based approach to retrospective comparative studies. J Gastrointest Surg, 2011, 15(2):378-387.
32.	Zhou Y, Zhao Y, Li B, et al. Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterology, 2010, 10:78.
33.	师礼鹏, 王一.国内外肝癌射频消融术与手术切除3年生存率Meta分析.齐鲁医学杂志, 2009, 24(05):413-415.
34.	杜娟, 邰沁文, 曹峻, 等.经皮热消融与手术切除治疗小肝癌疗效比较的系统评价.中华现代外科学杂志, 2009, 6(10):605-609.
35.	陈汝福, 肖调华, 周泉波, 等.射频消融治疗肝硬化型小肝癌临床效果的循证分析.中华外科杂志, 2008, 46(18):1413-1418.
36.	Chagnon S. Prospective randomized trial of radiofrequency ablation versus surgical resection for small hepatocellular carcinomas. J Radiol, 2007, 88(12):1842-1844.
37.	Chen MS, Li JQ, Zheng Y, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg, 2006, 243(3): 321-328.
38.	Huang J, Yan L, Cheng Z, et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg, 2010, 252(6):903-912.
39.	陈敏山, 李锦清, 梁惠宏, 等.经皮射频消融与手术切除治疗小肝癌的疗效比较.中华医学杂志, 2005, 85(2):80-83.
40.	Cho CM, Tak WY, Kweon YO, et al. The comparative results of radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma. Korean J Hepatol, 2005, 11(1):59-71.
41.	Vivarelli M, Guglielmi A, Ruzzenente A, et al. Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver. Ann Surg, 2004, 240(1): 102-107.
42.	李立新, 叶胜龙, 杨毕伟, 等.射频及手术切除在小肝癌治疗中价值的探讨.中国临床医学, 2004, 11(6):1011-1013.
43.	Guo WX, Zhai B, Lai EC, et al. Percutaneous radiofrequency ablation versus partial hepatectomy for multicentric small hepatocellular carcinomas:a nonrandomized comparative study. World J Surg, 2010, 34(11):2671-2676.
44.	Hasegawa K, Makuuchi M, Takayama T, et al. Surgical resection vs. percutaneous ablation for hepatocellular carcinoma:a preliminary report of the Japanese nationwide survey. J Hepatol, 2008, 49(4): 589-594.
45.	Hong SN, Lee SY, Choi MS, et al. Comparing the outcomes of radiofrequency ablation and surgery in patients with a single small hepatocellular carcinoma and well-preserved hepatic function. J Clin Gastroenterol, 2005, 39(3):247-252.
46.	步向阳, 王一, 葛忠, 等.小肝癌射频消融与手术切除的疗效比较.中华普通外科学文献(电子版), 2009, 3(02):127-131.
47.	Huang J, Hernandez-Alejandro R, Croome KP, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1, 061 cases. J Gastrointest Surg, 2011, 15(2):311-320.
48.	申权, 薛焕洲, 姜青锋, 等.射频消融与手术再切除治疗复发性肝癌的比较.中国肿瘤临床, 2008, 35(19):1088-1092.
49.	任正刚, 干育红, 樊嘉, 等.射频毁损术与再手术切除治疗复发性小肝癌对照研究.中华外科杂志, 2008, 46(21):1614-1616.
50.	张隆群, 王济明.射频消融与手术切除治疗肝癌并发症及生存率的临床对照研究.第三军医大学学报, 2007, 29(5):457-459.
51.	Montorsi M, Santambrogio R, Bianchi P, et al. Survival and recurrences after hepatic resection or radiofrequency for hepatocellular carcinoma in cirrhotic patients:a multivariate analysis. J Gastrointest Surg, 2005, 9(1):62-67, discussion 67-68.
52.	Abu-Hilal M, Primrose JN, Casaril A, et al. Surgical resection versus radiofrequency ablation in the treatment of small unifocal hepatocellular carcinoma. J Gastrointest Surg, 2008, 12(9):1521-1526.
53.	周铁, 仇毓东, 孔文韬, 等.小肝癌射频消融与手术切除的疗效分析.肝胆外科杂志, 2007, 15(6):424-427.
54.	Ogihara M, Wong LL, Machi J. Radiofrequency ablation versus surgical resection for single nodule hepatocellular carcinoma:longterm outcomes. HPB (Oxford), 2005, 7(3):214-221.
55.	Nanashima A, Tobinaga S, Masuda J, et al. Selecting treatment for hepatocellular carcinoma based on the results of hepatic resection and local ablation therapy. J Surg Oncol, 2010, 101(6):481-485.
56.	Hung HH, Chiou YY, Hsia CY, et al. Survival rates are comparable after radiofrequency ablation or surgery in patients with small hepatocellular carcinomas. Clin Gastroenterol Hepatol, 2011, 9(1):79-86.
57.	Nishikawa H, Inuzuka T, Takeda H, et al. Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma. BMC Gastroenterol, 2011, 11:143.
58.	Santambrogio R, Opocher E, Zuin M, et al. Surgical resection versus laparoscopic radiofrequency ablation in patients with hepatocellular carcinoma and Child-Pugh class a liver cirrhosis. Ann Surg Oncol, 2009, 16(12):3289-3298.
59.	Ueno S, Sakoda M, Kubo F, et al. Surgical resection versus radiofrequency ablation for small hepatocellular carcinomas within the Milan criteria. J Hepatobiliary Pancreat Surg, 2009, 16(3):359-366.
60.	彭振维, 徐立, 陈敏山, 等.原位射频消融与手术治疗小肝癌对比研究.中国实用外科杂志, 2008, 28(8):633-636.
61.	Hiraoka A, Horiike N, Yamashita Y, et al. Efficacy of radiofrequency ablation therapy compared to surgical resection in 164 patients in Japan with single hepatocellular carcinoma smaller than 3 cm, along with report of complications. Hepatogastroenterology, 2008, 55(88): 2171-2174.
62.	Lupo L, Panzera P, Giannelli G, et al. Single hepatocellular carcinoma ranging from 3 to 5 cm:radiofrequency ablation or resection? HPB (Oxford), 2007, 9(6):429-434.
63.	Yamakado K, Nakatsuka A, Takaki H, et al. Early-stage hepatocellular carcinoma:radiofrequency ablation combined with chemoembolization versus hepatectomy. Radiology, 2008, 247(1):260-266.
64.	Liang HH, Chen MS, Peng ZW, et al. Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma:a retrospective study. Ann Surg Oncol, 2008, 15(12):3484-3493.
65.	Wakai T, Shirai Y, Suda T, et al. Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or=4 cm. World J Gastroenterol, 2006, 12(4):546-552.
66.	Takahashi S, Kudo M, Chung H, et al. Outcomes of nontransplant potentially curative therapy for early-stage hepatocellular carcinoma in Child-Pugh stage A cirrhosis is comparable with liver transplantation. Dig Dis, 2007, 25(4):303-309.
67.	Farinati F, Sergio A, Baldan A, et al. Early and very early hepatocellular carcinoma:when and how much do staging and choice of treatment really matter? A multi-center study. BMC Cancer, 2009, 9: 33.
68.	高文, 陈敏华, 严昆, 等.射频消融治疗非手术适应证小肝癌疗效分析.中国医学影像技术, 2007, 23(02):254-257.
69.	Tashiro H, Aikata H, Waki K, et al. Treatment strategy for early hepatocellular carcinomas:comparison of radiofrequency ablation with or without transcatheter arterial chemoembolization and surgical resection. J Surg Oncol, 2011, 104(1):3-9.
70.	Wong J, Lee KF, Lee PS, et al. Radiofrequency ablation for 110 malignant liver tumours:preliminary results on percutaneous and surgical approaches. Asian J Surg, 2009, 32(1):13-20.
71.	Takayama T, Makuuchi M, Hasegawa K. Single HCC smaller than 2 cm:surgery or ablation?:surgeon's perspective. J Hepatobiliary Pancreat Sci, 2010, 17(4):422-424.
72.	吕明德, 匡铭, 梁力建, 等.手术切除和经皮热消融治疗早期肝癌的随机对照临床研究.中华医学杂志, 2006, 86(12):801-805.
73.	Cho YK, Rhim H, Noh S. Radiofrequency ablation versus surgical resection as primary treatment of hepatocellular carcinoma meeting the Milan criteria:a systematic review. J Gastroenterol Hepatol, 2011, 26(9):1354-1360.
74.	Zhang JH, Shang HC, Zhang BL. How to assess the quality of systematic review and meta-analysis. Zhong Xi Yi Jie He Xue Bao, 2008, 6(4):337-340.
75.	Guyatt GH, Oxman AD, Akl EA, et al. GRADE guidelines:1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4):383-394.

1. Llovet JM, Lencioni R, di Bisceglie AM, et al. EASL-EORTC Clinical Practice Guidelines:Management of hepatocellular carcinoma. J Hepatol, 2012, 56(4):908-943.
2. Soerjomataram I, Lortet-Tieulent J, Parkin DM, et al. Global burden of cancer in 2008:a systematic analysis of disability-adjusted lifeyears in 12 world regions. Lancet, 2012, 380(9856):1840-1850.
3. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwise:IARC cancerBase No.10[Internet]. 2010, 24. Available at: http://globocan.iarc.fr.[Accessed11, 2012].
4. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917.
5. Bruix J, Sherman M. Management of hepatocellular carcinoma:an update. Hepatology, 2011, 53(3):1020-1022.
6. Kobayashi M, Ikeda K, Kawamura Y, et al. High serum des-gammacarboxy prothrombin level predicts poor prognosis after radiofrequency ablation of hepatocellular carcinoma. Cancer, 2009, 115(3):571-580.
7. Ye SL. Expert consensus on standardization of the management of primary liver cancer. Zhonghua Gan Zang Bing Za Zhi, 2009, 17(6): 403-410.
8. Crocetti L, de Baere T, Lencioni R. Quality Improvement Guidelines for Radiofrequency Ablation of Liver Tumours. Cardiovasc Intervent Radiol, 2010, 33(1):11-17.
9. Guglielmi A, Ruzzenente A, Valdegamberi A, et al. Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis. J Gastrointest Surg, 2008, 12(1):192-198.
10. Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol, 2012, 57(4):794-802.
11. Wang JH, Wang CC, Hung CH, et al. Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma. J Hepatol, 2012, 56(2):412-418.
12. Peng ZW, Lin XJ, Zhang YJ, et al. Radiofrequency ablation versus hepatic resection for the treatment of hepatocellular carcinomas 2cm or smaller:a retrospective comparative study. Radiology, 2012, 262(3):1022-1033.
13. Xu G, Qi FZ, Zhang JH, et al. Meta-analysis of surgical resection and radiofrequency ablation for early hepatocellular carcinoma. World J Surg Oncol, 2012, 10(1):163.
14. Liu Z, Zhou Y, Zhang P, et al. Meta-analysis of the therapeutic effect of hepatectomy versus radiofrequency ablation for the treatment of hepatocellular carcinoma (Structured abstract). Surg Laparosc Endosc Percutan Tech, 2010(3):130-140.
15. Liu JG, Wang YJ, Du Z. Radiofrequency ablation in the treatment of small hepatocellular carcinoma:a meta analysis. World J Gastroenterol, 2010, 16(27):3450-3456.
16. 孙彪, 郑传胜, 冯敢生, 等.射频消融对比手术切除治疗小肝癌的Meta分析.世界华人消化杂志, 2011, 19(31):3255-3263.
17. Li L, Zhang JL, Liu XH, et al. Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: A meta-analysis. J Gastroenterol Hepatol, 2012, 27(1):51-58.
18. Xie XQ, Dendukuri N, McGregor M. Percutaneous radiofrequency ablation for the treatment of early stage hepatocellular carcinoma: A health technology assessment. Int J Technol Assess Health Care, 2010, 26(4):390-397.
19. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses:the PRISMA statement. PLoS Med, 2009, 6(7):e1000097.
20. Oxman AD, Guyatt GH, Singer J, et al. Agreement among reviewers of review articles. J Clin Epidemiol, 1991, 44(1):91-98.
21. Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol, 1991, 44(11):1271-1278.
22. Slim K, Nini E, Forestier D, et al. Methodological index for nonrandomized studies (minors):development and validation of a new instrument. ANZ J Surg, 2003, 73(9):712-716.
23. Higgins JP, Green S. Conchrane Handbook for Systematic Reviews of Interventions 5.1.0[updated March 2011]. The Cochrane Collaboration2011.
24. Tiong L, Maddern GJ. Systematic review and meta-analysis of survival and disease recurrence after radiofrequency ablation for hepatocellular carcinoma. Br J Surg, 2011, 98(9):1210-1224.
25. Minami Y, Kudo M. Radiofrequency ablation of hepatocellular carcinoma:a literature review. Int J Hepatol, 2011, 2011:104685.
26. Lau WY, Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma:a systematic review. Ann Surg, 2009, 249(1):20-25.
27. 黄子明, 张洪义, 李志杰, 等.射频消融与手术切除治疗小肝癌的Meta分析.中国现代普通外科进展, 2012, 15(03):211-215.
28. 游伟, 李相成.小肝癌射频消融与手术切除疗效的Meta分析.南京医科大学学报(自然科学版), 2012, 32(08):1179-1184.
29. 周大臣, 耿小平, 朱立新, 等.经皮射频消融与肝切除治疗小肝癌的疗效比较meta分析.中华外科杂志, 2011, 49(12):1132-1136.
30. 王振, 钱叶本.小肝癌射频消融术与手术切除术疗效的Meta分析.肝胆外科杂志, 2011, 19(01):23-27.
31. Gravante G, Overton J, Sorge R, et al. Radiofrequency ablation versus resection for liver tumours:an evidence-based approach to retrospective comparative studies. J Gastrointest Surg, 2011, 15(2):378-387.
32. Zhou Y, Zhao Y, Li B, et al. Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterology, 2010, 10:78.
33. 师礼鹏, 王一.国内外肝癌射频消融术与手术切除3年生存率Meta分析.齐鲁医学杂志, 2009, 24(05):413-415.
34. 杜娟, 邰沁文, 曹峻, 等.经皮热消融与手术切除治疗小肝癌疗效比较的系统评价.中华现代外科学杂志, 2009, 6(10):605-609.
35. 陈汝福, 肖调华, 周泉波, 等.射频消融治疗肝硬化型小肝癌临床效果的循证分析.中华外科杂志, 2008, 46(18):1413-1418.
36. Chagnon S. Prospective randomized trial of radiofrequency ablation versus surgical resection for small hepatocellular carcinomas. J Radiol, 2007, 88(12):1842-1844.
37. Chen MS, Li JQ, Zheng Y, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg, 2006, 243(3): 321-328.
38. Huang J, Yan L, Cheng Z, et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg, 2010, 252(6):903-912.
39. 陈敏山, 李锦清, 梁惠宏, 等.经皮射频消融与手术切除治疗小肝癌的疗效比较.中华医学杂志, 2005, 85(2):80-83.
40. Cho CM, Tak WY, Kweon YO, et al. The comparative results of radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma. Korean J Hepatol, 2005, 11(1):59-71.
41. Vivarelli M, Guglielmi A, Ruzzenente A, et al. Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver. Ann Surg, 2004, 240(1): 102-107.
42. 李立新, 叶胜龙, 杨毕伟, 等.射频及手术切除在小肝癌治疗中价值的探讨.中国临床医学, 2004, 11(6):1011-1013.
43. Guo WX, Zhai B, Lai EC, et al. Percutaneous radiofrequency ablation versus partial hepatectomy for multicentric small hepatocellular carcinomas:a nonrandomized comparative study. World J Surg, 2010, 34(11):2671-2676.
44. Hasegawa K, Makuuchi M, Takayama T, et al. Surgical resection vs. percutaneous ablation for hepatocellular carcinoma:a preliminary report of the Japanese nationwide survey. J Hepatol, 2008, 49(4): 589-594.
45. Hong SN, Lee SY, Choi MS, et al. Comparing the outcomes of radiofrequency ablation and surgery in patients with a single small hepatocellular carcinoma and well-preserved hepatic function. J Clin Gastroenterol, 2005, 39(3):247-252.
46. 步向阳, 王一, 葛忠, 等.小肝癌射频消融与手术切除的疗效比较.中华普通外科学文献(电子版), 2009, 3(02):127-131.
47. Huang J, Hernandez-Alejandro R, Croome KP, et al. Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1, 061 cases. J Gastrointest Surg, 2011, 15(2):311-320.
48. 申权, 薛焕洲, 姜青锋, 等.射频消融与手术再切除治疗复发性肝癌的比较.中国肿瘤临床, 2008, 35(19):1088-1092.
49. 任正刚, 干育红, 樊嘉, 等.射频毁损术与再手术切除治疗复发性小肝癌对照研究.中华外科杂志, 2008, 46(21):1614-1616.
50. 张隆群, 王济明.射频消融与手术切除治疗肝癌并发症及生存率的临床对照研究.第三军医大学学报, 2007, 29(5):457-459.
51. Montorsi M, Santambrogio R, Bianchi P, et al. Survival and recurrences after hepatic resection or radiofrequency for hepatocellular carcinoma in cirrhotic patients:a multivariate analysis. J Gastrointest Surg, 2005, 9(1):62-67, discussion 67-68.
52. Abu-Hilal M, Primrose JN, Casaril A, et al. Surgical resection versus radiofrequency ablation in the treatment of small unifocal hepatocellular carcinoma. J Gastrointest Surg, 2008, 12(9):1521-1526.
53. 周铁, 仇毓东, 孔文韬, 等.小肝癌射频消融与手术切除的疗效分析.肝胆外科杂志, 2007, 15(6):424-427.
54. Ogihara M, Wong LL, Machi J. Radiofrequency ablation versus surgical resection for single nodule hepatocellular carcinoma:longterm outcomes. HPB (Oxford), 2005, 7(3):214-221.
55. Nanashima A, Tobinaga S, Masuda J, et al. Selecting treatment for hepatocellular carcinoma based on the results of hepatic resection and local ablation therapy. J Surg Oncol, 2010, 101(6):481-485.
56. Hung HH, Chiou YY, Hsia CY, et al. Survival rates are comparable after radiofrequency ablation or surgery in patients with small hepatocellular carcinomas. Clin Gastroenterol Hepatol, 2011, 9(1):79-86.
57. Nishikawa H, Inuzuka T, Takeda H, et al. Comparison of percutaneous radiofrequency thermal ablation and surgical resection for small hepatocellular carcinoma. BMC Gastroenterol, 2011, 11:143.
58. Santambrogio R, Opocher E, Zuin M, et al. Surgical resection versus laparoscopic radiofrequency ablation in patients with hepatocellular carcinoma and Child-Pugh class a liver cirrhosis. Ann Surg Oncol, 2009, 16(12):3289-3298.
59. Ueno S, Sakoda M, Kubo F, et al. Surgical resection versus radiofrequency ablation for small hepatocellular carcinomas within the Milan criteria. J Hepatobiliary Pancreat Surg, 2009, 16(3):359-366.
60. 彭振维, 徐立, 陈敏山, 等.原位射频消融与手术治疗小肝癌对比研究.中国实用外科杂志, 2008, 28(8):633-636.
61. Hiraoka A, Horiike N, Yamashita Y, et al. Efficacy of radiofrequency ablation therapy compared to surgical resection in 164 patients in Japan with single hepatocellular carcinoma smaller than 3 cm, along with report of complications. Hepatogastroenterology, 2008, 55(88): 2171-2174.
62. Lupo L, Panzera P, Giannelli G, et al. Single hepatocellular carcinoma ranging from 3 to 5 cm:radiofrequency ablation or resection? HPB (Oxford), 2007, 9(6):429-434.
63. Yamakado K, Nakatsuka A, Takaki H, et al. Early-stage hepatocellular carcinoma:radiofrequency ablation combined with chemoembolization versus hepatectomy. Radiology, 2008, 247(1):260-266.
64. Liang HH, Chen MS, Peng ZW, et al. Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma:a retrospective study. Ann Surg Oncol, 2008, 15(12):3484-3493.
65. Wakai T, Shirai Y, Suda T, et al. Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or=4 cm. World J Gastroenterol, 2006, 12(4):546-552.
66. Takahashi S, Kudo M, Chung H, et al. Outcomes of nontransplant potentially curative therapy for early-stage hepatocellular carcinoma in Child-Pugh stage A cirrhosis is comparable with liver transplantation. Dig Dis, 2007, 25(4):303-309.
67. Farinati F, Sergio A, Baldan A, et al. Early and very early hepatocellular carcinoma:when and how much do staging and choice of treatment really matter? A multi-center study. BMC Cancer, 2009, 9: 33.
68. 高文, 陈敏华, 严昆, 等.射频消融治疗非手术适应证小肝癌疗效分析.中国医学影像技术, 2007, 23(02):254-257.
69. Tashiro H, Aikata H, Waki K, et al. Treatment strategy for early hepatocellular carcinomas:comparison of radiofrequency ablation with or without transcatheter arterial chemoembolization and surgical resection. J Surg Oncol, 2011, 104(1):3-9.
70. Wong J, Lee KF, Lee PS, et al. Radiofrequency ablation for 110 malignant liver tumours:preliminary results on percutaneous and surgical approaches. Asian J Surg, 2009, 32(1):13-20.
71. Takayama T, Makuuchi M, Hasegawa K. Single HCC smaller than 2 cm:surgery or ablation?:surgeon's perspective. J Hepatobiliary Pancreat Sci, 2010, 17(4):422-424.
72. 吕明德, 匡铭, 梁力建, 等.手术切除和经皮热消融治疗早期肝癌的随机对照临床研究.中华医学杂志, 2006, 86(12):801-805.
73. Cho YK, Rhim H, Noh S. Radiofrequency ablation versus surgical resection as primary treatment of hepatocellular carcinoma meeting the Milan criteria:a systematic review. J Gastroenterol Hepatol, 2011, 26(9):1354-1360.
74. Zhang JH, Shang HC, Zhang BL. How to assess the quality of systematic review and meta-analysis. Zhong Xi Yi Jie He Xue Bao, 2008, 6(4):337-340.
75. Guyatt GH, Oxman AD, Akl EA, et al. GRADE guidelines:1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4):383-394.

Chinese Journal of Evidence-Based Medicine

A Systematic Assessment of the Quality of Systematic Reviews/Meta-Analyses in Radiofrequency Ablation versus Hepatic Resection for Small Hepatocellular Carcinoma^△

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A Systematic Assessment of the Quality of Systematic Reviews/Meta-Analyses in Radiofrequency Ablation versus Hepatic Resection for Small Hepatocellular Carcinoma△

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A Systematic Assessment of the Quality of Systematic Reviews/Meta-Analyses in Radiofrequency Ablation versus Hepatic Resection for Small Hepatocellular Carcinoma^△