Summary of findings 2. Percutaneous alcohol injection versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma.
| Percutaneous alcohol injection versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma | |||||
|
Patient or population: people with early‐ or very early‐stage hepatocellular carcinoma ineligible for surgery
Settings: secondary or tertiary care
Intervention: percutaneous alcohol injection Control: radiofrequency ablation | |||||
| Outcomes | Illustrative risks* (95% CI) | Relative effect (95% CI) | No. of participants (trials) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Radiofrequency ablation | Percutaneous alcohol injection | ||||
|
Mortality at maximal follow‐up Follow‐up: 23 months to 37 months |
300 per 1000 | 447 per 1000 (354 to 564) | HR 1.49 (1.18 to 1.88) | 882 (5 trials) | ⊕⊝⊝⊝ very low1,2,3 |
|
Cancer‐related mortality at maximal follow‐up Follow‐up: 23 months to 37 months |
96 per 1000 | 188 per 1000 (115 to 292) | OR 2.18 (1.22 to 3.89) | 458 (3 trials) | ⊕⊕⊝⊝ low1,2 |
|
Serious adverse events (number of participants) Follow‐up: 23 months to 36 months |
20 per 1000 | 13 per 1000 (4 to 47) | OR 0.67 (0.19 to 2.40) | 365 (3 trials) | ⊕⊝⊝⊝ very low1,2,3 |
|
Serious adverse events (number of events) Follow‐up: 37 months |
34 per 1000 | 26 per 1000 (6 to 118) | Rate ratio 0.78 (0.17 to 3.47) | 232 (1 trial) | ⊕⊝⊝⊝ very low1,2,3 |
| Health‐related quality of life | None of the trials reported this outcome. | ||||
| *The basis for the assumed risk for all‐cause mortality is the approximate control group proportions at two to three years reported in the Kaplan‐Meier curves in the trials that reported mortality at maximal‐follow‐up. We have assumed proportional hazards. The basis for the assumed risk for other outcomes is based on the mean control group proportion. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HR: hazard ratio; OR: odds ratio; RR: rate ratio | |||||
| 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. | |||||
1Downgraded one level because of within‐study risk of bias: there was unclear or high risk of bias in the trial(s). 2Downgraded one level because of imprecision: the sample size was small. 3Downgraded one level because of imprecision: the confidence intervals overlapped clinically significant effect and clinically insignificant effect.