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. 2017 Mar 28;2017(3):CD011650. doi: 10.1002/14651858.CD011650.pub2

Summary of findings 3. Laser ablation versus radiofrequency ablation for people with early‐ or very early‐stage hepatocellular carcinoma.

Laser ablation 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: laser ablation
Control: radiofrequency ablation
Outcomes Illustrative comparative risks* (95% CI) Relative effect
(95% CI) No. of participants
(trials) Quality of the evidence
(GRADE)
Assumed risk Corresponding risk
Radiofrequency ablation Laser ablation
Mortality at maximal follow‐up
Follow‐up: not stated
300 per 1000 468 per 1000
(262 to 731) HR 1.77 
(0.85 to 3.68) 140
(1 trial) ⊕⊝⊝⊝
very low1,2,3
Cancer‐related mortality at maximal follow‐up
Follow‐up: not stated
96 per 1000 118 per 1000
(49 to 258) OR 1.26 
(0.49 to 3.27) 140
(1 trial) ⊕⊝⊝⊝
very low1,2,3
Serious adverse events (number of participants)
Follow‐up: 12 months in 1 trial and not stated in another trial
20 per 1000 20 per 1000
(1 to 250) OR 1.00 
(0.06 to 16.31) 170
(2 trials) ⊕⊝⊝⊝
very low1,2,3
Serious adverse events (number of events) None of the trials reported this outcome.
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
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.