A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma

BackgroundThe comparative evaluation of laparoscopic and percutaneous techniques for liver radiofrequency ablation remains unexplored. This study aims to determine the most effective ablation technique and patient selection for hepatocellular carcinoma (HCC) by analyzing the efficacy and safety of l...

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Main Authors: Ya-Qiong Wang, Zhen-Kun Tan, Zha Peng, Hai Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1559343/full
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author Ya-Qiong Wang
Ya-Qiong Wang
Zhen-Kun Tan
Zhen-Kun Tan
Zha Peng
Zha Peng
Hai Huang
author_facet Ya-Qiong Wang
Ya-Qiong Wang
Zhen-Kun Tan
Zhen-Kun Tan
Zha Peng
Zha Peng
Hai Huang
author_sort Ya-Qiong Wang
collection DOAJ
description BackgroundThe comparative evaluation of laparoscopic and percutaneous techniques for liver radiofrequency ablation remains unexplored. This study aims to determine the most effective ablation technique and patient selection for hepatocellular carcinoma (HCC) by analyzing the efficacy and safety of laparoscopic radiofrequency ablation (LRFA) versus percutaneous radiofrequency ablation (PRFA).MethodsTwo investigators (Y-QW and PZ) independently performed a literature search in the Cochrane Library, PubMed, Web of Science and Embase databases. Study quality was assessed using the Newcastle–Ottawa Scale or Cochrane risk-of-bias tool. Meta-analysis was conducted with Review Manager 5.4, applying either fixed- or random-effects models depending on study heterogeneity. The chi-square test (χ²) and I² statistics were employed for heterogeneity analysis.ResultsEight publications involving 1059 patients were included. Among them, 456 underwent LRFA and 603 underwent PRFA. LRFA showed a significantly better 3-year RFS than PRFA (OR: 1.89, 95% CI: 1.27-2.83, p = 0.002), the incidence rate of local recurrence was significantly fewer in the LRFA group (OR: 0.40, 95% CI: 0.23-0.69, p = 0.0010), but the postoperative hospital stay time was slightly shorter in the PFRA group (MD = 1.30; 95% CI 0.26 to 2.35; p=0. 01). Patients in the LRFA group had no significant difference in total postoperative complications, ablation success rates, overall survival (OS) and 1,5-year disease-free survival (DFS).ConclusionBoth LRFA and PRFA are effective treatments for HCC. LRFA shows better oncologic outcomes, including lower local recurrence and improved mid-term DFS. PRFA is simpler, less invasive and shorter hospital stays. The choice should be tailored to individual patient needs, considering tumor characteristics, comorbidities, and available expertise. Future research should focus on large-scale, prospective trials to validate these findings.Systematic review and registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024601797.
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spelling doaj-art-dfa7be01abdb4e00b48303b0c210de1b2025-08-20T02:46:20ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.15593431559343A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinomaYa-Qiong Wang0Ya-Qiong Wang1Zhen-Kun Tan2Zhen-Kun Tan3Zha Peng4Zha Peng5Hai Huang6Hepatobiliary Surgical Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaGraduate Institute, Guangxi Medical University, Nanning, Guangxi, ChinaHepatobiliary Surgical Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaGraduate Institute, Guangxi Medical University, Nanning, Guangxi, ChinaHepatobiliary Surgical Department, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaGraduate Institute, Guangxi Medical University, Nanning, Guangxi, ChinaHepatobiliary Surgical Department, Wuming Hospital of Guangxi Medical University, Nanning, Guangxi, ChinaBackgroundThe comparative evaluation of laparoscopic and percutaneous techniques for liver radiofrequency ablation remains unexplored. This study aims to determine the most effective ablation technique and patient selection for hepatocellular carcinoma (HCC) by analyzing the efficacy and safety of laparoscopic radiofrequency ablation (LRFA) versus percutaneous radiofrequency ablation (PRFA).MethodsTwo investigators (Y-QW and PZ) independently performed a literature search in the Cochrane Library, PubMed, Web of Science and Embase databases. Study quality was assessed using the Newcastle–Ottawa Scale or Cochrane risk-of-bias tool. Meta-analysis was conducted with Review Manager 5.4, applying either fixed- or random-effects models depending on study heterogeneity. The chi-square test (χ²) and I² statistics were employed for heterogeneity analysis.ResultsEight publications involving 1059 patients were included. Among them, 456 underwent LRFA and 603 underwent PRFA. LRFA showed a significantly better 3-year RFS than PRFA (OR: 1.89, 95% CI: 1.27-2.83, p = 0.002), the incidence rate of local recurrence was significantly fewer in the LRFA group (OR: 0.40, 95% CI: 0.23-0.69, p = 0.0010), but the postoperative hospital stay time was slightly shorter in the PFRA group (MD = 1.30; 95% CI 0.26 to 2.35; p=0. 01). Patients in the LRFA group had no significant difference in total postoperative complications, ablation success rates, overall survival (OS) and 1,5-year disease-free survival (DFS).ConclusionBoth LRFA and PRFA are effective treatments for HCC. LRFA shows better oncologic outcomes, including lower local recurrence and improved mid-term DFS. PRFA is simpler, less invasive and shorter hospital stays. The choice should be tailored to individual patient needs, considering tumor characteristics, comorbidities, and available expertise. Future research should focus on large-scale, prospective trials to validate these findings.Systematic review and registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024601797.https://www.frontiersin.org/articles/10.3389/fonc.2025.1559343/fullmeta-analysishepatocellular carcinoma (HCC)laparoscopic radiofrequency ablationpercutaneous radiofrequency ablation (PRFA)radiofrequency ablation (RFA)
spellingShingle Ya-Qiong Wang
Ya-Qiong Wang
Zhen-Kun Tan
Zhen-Kun Tan
Zha Peng
Zha Peng
Hai Huang
A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
Frontiers in Oncology
meta-analysis
hepatocellular carcinoma (HCC)
laparoscopic radiofrequency ablation
percutaneous radiofrequency ablation (PRFA)
radiofrequency ablation (RFA)
title A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
title_full A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
title_fullStr A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
title_full_unstemmed A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
title_short A systematic review and meta-analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
title_sort systematic review and meta analysis of the comparison of laparoscopic radiofrequency ablation to percutaneous radiofrequency ablation for hepatocellular carcinoma
topic meta-analysis
hepatocellular carcinoma (HCC)
laparoscopic radiofrequency ablation
percutaneous radiofrequency ablation (PRFA)
radiofrequency ablation (RFA)
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1559343/full
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