Meta-analysis of Risk Factors for Local Recurrence and Early Recurrence After Ablation Procedure of Liver Cancer
Objective To systematically evaluate the risk factors of local recurrence and early recurrence(within 1 year after operation)after ablation procedure of liver cancer.Methods CNKI,WanFang Data,VIP,Web of science,PubMed,EMbase,SinoMed and The Cochrane Library databases were searched by computer to collect case-control studies and cohort studies on the risk factors of recurrence after ablation procedure of liver cancer from the database construction to May 2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results 22 articles were included,published from 2012 to 2022,and 2 articles were excluded according to the inclusion criteria.Of 14 articles about local recurrence and 6 articles about early recurrence were included,with 5836 patients and 728 patients respectively.The results of Meta-analysis showed that the risk factors of local recurrence included tumor diameter＞2 cm(RR=1.92,95％CI:1.54-2.38,P＜0.000 01),tumor near large blood vessels(RR=2.36,95％CI:1.79-3.1 1,P＜0.000 01),tumor near the diaphragm(RR=2.50,95％CI:1.61-3.87,P＜0.000 1),and other risk factors included insufficient ablation safety boundary and low signal of ADC map.The risk factors for early recurrence included the number of tumors ≥ 2(OR=4.02,95％CI:2.25-7.17,P＜0.000 01),AFP＞400 ng/ml(OR=4.19,95％CI 1.47-11.93,P=0.007),ALB ≤35 g/L(OR=0.36,95％CI:.0.16-0.79,P=0.01).Conclusion Strictly control the inclusion criteria of ablation.For the large number of tumors,large diameter,high-risk location,high tumor markers and high-risk signs in combination with imaging,combined treatment or surgical resection is feasible to reduce the postoperative recurrence rate of liver cancer.
万方数据
维普
