Cochrane · systematic review · CD011650
Management of people with early‐ or very early‐stage hepatocellular carcinoma
Majumdar, A, Roccarina, D, Thorburn, D, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Hepato-BiliaryAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
25
current version
GRADE rated
17
No studies
8
Included studies
NR
No studies 8 · 32%Ungraded 0 · 0%Very low 13 · 52%Low 4 · 16%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Surgery versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma
Population: people with early‐ or very early‐stage hepatocellular carcinoma eligible for surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality at maximal Surgery vs radiofrequency ablation | HR 0.8 [0.6, 1.08] | 4 studies · 574 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Cancer‐related mortality at maximal Surgery vs radiofrequency ablation | OR 0.35 [0.19, 0.65] | 1 study · 230 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events (number of participants) Surgery vs radiofrequency ablation | OR 17.96 [2.28, 141.6] | 1 study · 120 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events (number of events) Surgery vs radiofrequency ablation | Rate ratio 7.02 [2.29, 21.46] | 2 studies · 391 participants | Low Downgraded: risk of bias, imprecision |
Health‐related quality of life Surgery vs radiofrequency ablation | no estimate extracted | NR | No studies |
Percutaneous alcohol injection versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma
Population: people with early‐ or very early‐stage hepatocellular carcinoma ineligible for surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality at maximal Percutaneous alcohol injection vs radiofrequency ablation | HR 1.49 [1.18, 1.88] | 5 studies · 882 participants | Very low Downgraded: risk of bias, imprecision |
Cancer‐related mortality at maximal Percutaneous alcohol injection vs radiofrequency ablation | OR 2.18 [1.22, 3.89] | 3 studies · 458 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events (number of participants) Percutaneous alcohol injection vs radiofrequency ablation | OR 0.67 [0.19, 2.4] | 3 studies · 365 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of events) Percutaneous alcohol injection vs radiofrequency ablation | Rate ratio 0.78 [0.17, 3.47] | 1 study · 232 participants | Very low Downgraded: risk of bias, imprecision |
Health‐related quality of life Percutaneous alcohol injection vs radiofrequency ablation | no estimate extracted | NR | No studies |
Laser ablation versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma
Population: people with early‐ or very early‐stage hepatocellular carcinoma ineligible for surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality at maximal Laser ablation vs radiofrequency ablation | HR 1.77 [0.85, 3.68] | 1 study · 140 participants | Very low Downgraded: risk of bias, imprecision |
Cancer‐related mortality at maximal Laser ablation vs radiofrequency ablation | OR 1.26 [0.49, 3.27] | 1 study · 140 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of participants) Laser ablation vs radiofrequency ablation | OR 1 [0.06, 16.31] | 2 studies · 170 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of events) Laser ablation vs radiofrequency ablation | no estimate extracted | NR | No studies |
Health‐related quality of life Laser ablation vs radiofrequency ablation | no estimate extracted | NR | No studies |
Transarterial embolisation plus radiofrequency ablation versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma
Population: people with early‐ or very early‐stage hepatocellular carcinoma ineligible for surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality at maximal Transarterial embolisation plus radiofrequency ablation vs radiofrequency ablation | HR 1.12 [0.48, 2.58] | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Cancer‐related mortality at maximal Transarterial embolisation plus radiofrequency ablation vs radiofrequency ablation | no estimate extracted | NR | No studies |
Serious adverse events (number of participants) Transarterial embolisation plus radiofrequency ablation vs radiofrequency ablation | OR 2.11 [0.18, 25.35] | 2 studies · 84 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of events) Transarterial embolisation plus radiofrequency ablation vs radiofrequency ablation | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias, imprecision |
Health‐related quality of life Transarterial embolisation plus radiofrequency ablation vs radiofrequency ablation | no estimate extracted | NR | No studies |
Transarterial embolisation plus percutaneous alcohol injection versus percutaneous alcohol injection for people with early‐ or very early‐stage hepatocellular carcinoma
Population: people with early‐ or very early‐stage hepatocellular carcinoma ineligible for surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality at maximal Transarterial embolisation plus percutaneous alcohol injection vs percutaneous alcohol injection | HR 0.81 [0.65, 1.01] | 2 studies · 202 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Cancer‐related mortality at maximal Transarterial embolisation plus percutaneous alcohol injection vs percutaneous alcohol injection | OR 0.07 [0, 1.41] | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of participants) Transarterial embolisation plus percutaneous alcohol injection vs percutaneous alcohol injection | OR 5.41 [0.25, 118.34] | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |
Serious adverse events (number of events) Transarterial embolisation plus percutaneous alcohol injection vs percutaneous alcohol injection | no estimate extracted | NR | No studies |
Health‐related quality of life Transarterial embolisation plus percutaneous alcohol injection vs percutaneous alcohol injection | no estimate extracted | NR | No studies |