Repeat resection versus percutaneous ablation for recurrent hepatocellular carcinoma: a meta-analysis

Introduction
Both repeat resection (RR) and percutaneous ablation (PA) have been used for treating recurrent hepatocellular carcinoma (rHCC). Each method has its advantages and disadvantages.

Material and methods
Relevant articles published in the PubMed, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases published as of April 2022 were identified. Primary endpoints for this meta-analysis included patient overall survival (OS) and disease-free survival (DFS), whereas secondary endpoints included rates of repeat recurrence, complications, and the duration of hospitalization.

Results
This meta-analysis included a total of 6 relevant studies. Pooled repeat recurrence rates were comparable between the PA and RR groups (p = 0.09), although the pooled 5-year DFS rate (p = 0.01), DFS duration (p = 0.02), and 3-year OS rate (p = 0.04) in the RR group were considerably higher than in the PA group. Pooled rates of both Grade 1/2 (p = 0.04) and Grade 3/4 (p = 0.001) complications, however, were significantly lower for patients who underwent PA as compared to patients who underwent RR. PA was associated with a significantly shorter hospitalization duration relative to RR in this patient cohort (p = 0.0002).

Conclusions
According to the obtained findings, RR may be associated with better long-term disease control in rHCC patients than PA, whereas PA is associated with a better safety profile and a shorter duration of hospitalization.