Summary of findings for the main comparison. Percutaneous ethanol injection (PEI) or percutaneous acetic acid injection (PAI) for early hepatocellular carcinoma (HCC).
| PEI versus PAI or surgery for early HCC | |||||
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Patient or population: hospitalised people with early HCC treated with PEI, PAI, or surgery. Settings: Taiwanese and Japanese university and adjunct teaching hospitals. Intervention: PEI. Comparison: PAI or surgery. | |||||
| Outcomes | Comparison |
No. of trials |
Hazard ratio (95% CI) | No. of participants | Quality of the evidence (GRADE) |
| PEI versus PAI | |||||
| Overall survival | PAI | 2 |
HR 1.47 (0.68 to 3.19) |
185 | ⊕⊕⊝⊝ low1 |
| Recurrence‐free survival | PAI | 2 |
HR 1.42 (0.68 to 2.94) |
185 | ⊕⊕⊝⊝ low1 |
| Number and type of adverse events | PAI | 2 | Pain reported in both groups. Data not extractable for HR or OR. | ||
| Duration of hospital stay | PAI | 1 |
Mean PAI: 2.2 days (range 2 to 5) versus PEI: 1.7 days (range 2 to 3) |
125 | ⊕⊝⊝⊝ very low2 |
| Quality of life | PAI | 2 | No data were provided. | ||
| PEI versus surgery | |||||
| Overall survival | Surgery | 1 |
HR 1.57 (0.53 to 4.61) |
76 | ⊕⊝⊝⊝ very low3 |
| Recurrence‐free survival | Surgery | 1 |
HR 1.35 (0.69 to 2.63) |
76 | ⊕⊝⊝⊝ very low3 |
| Number and type of adverse events | Surgery | 1 | Insufficient amount of data provided. | 76 | ⊕⊝⊝⊝ very low4 |
| Duration of hospital stay | Surgery | 1 | No data were provided. | ||
| Quality of life | Surgery | 1 | No data were provided. | ||
| GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate. CI: confidence interval; HR: hazard ratio, MD: mean difference. | |||||
1 Graded as low, due to the risk of bias. Only one trial with low risk of bias was available and trial sequential analysis of both the high and low risk of bias trial revealed an insufficient number of included participants. 2 Graded as very low, as only one trial with low risk of bias was available. 3 Graded as very low, as only one trial of high risk of bias was available. 4 Graded as very low, as only one trial of high risk of bias was available and data presentation was not sufficiently precise.