摘要
Objective： To evaluate the comparative therapeutic efficacy of radiofrequency ablation （RFA） and hepatic resection （HR） for breast cancer liver metastases （BCLMs）. Methods： Studies that had examined the outcomes for both RFA and HR for BCLM were identified by searching the electronic databases PubMed, EMBASE, and the Cochrane Library. Pooled analyzes of the overall survival （OS）, disease-free survival （DFS）, and short-term outcomes of BCLM were performed. Results： Patients with BCLM gained many more survival benefits from HR than from RFA with regard to the 3-year OS rate （combined odds ratio （OR） 0.41, 95% confidence interval （CI） 0.29-0.59, P〈0.001）, 5-year OS rate （combined OR 0.38, 95% CI 0.32-0.46, P〈0.001）, 3-year DFS （combined OR 0.36, 95% CI 0.27-0.49, P〈0.001）, and 5-year DFS （combined OR 0.51, 95% CI 0.40-0.66, P〈0.001）. RFA had fewer postoperative compli- cations （combined OR 0.30, 95% CI 0.20-0.44, P〈0.001） and shorter hospital stays （combined OR -9.01, 95% CI -13.49-4.54, P〈0.001） than HR. Conclusions： HR takes precedence over RFA in the treatment of patients with BCLM, considering the better survival rate. RFA gives rise to fewer complications and can be carried out with a shorter hos- pital stay, compared to HR. RFA should be reserved for patients who are not optimum candidates for resection.
目的:评估射频消融术(RFA)和肝切除术(HR)治疗乳腺癌肝转移(BCLM)的效果。创新点:首次采用meta分析的方法,精确评估RFA和HR治疗BCLM的效果,解决不同研究产生不同结论的矛盾。方法:系统收集截止到2017年3月所有与RFA和HR治疗BCLM的效果相关文献,评价文献质量、提取数据并计算癌症预后相关指标的优势比(OR)及其95%置信区间(CI)。结论:HR比RFA对于提高BCLM患者生存率有更大优势;RFA并发症少、可重复、患者术后住院时间短,具有明显微创优势。对于不适合行切除治疗的患者可考虑行RFA治疗。
