Table 1.
Recent Studies Comparing Treatment Modalities in Patients with Recurrent Hepatocellular Carcinoma
| Author | Year | Type of Study | Selection Criteria | Overall Survival | Disease-Free Survival | Mortality | Major Complications |
|---|---|---|---|---|---|---|---|
| Repeat liver resection versus RFA | |||||||
| Xia et al19 | 2020 | RCT | Early disease (BCLC 0/A) | Comparable 5-year OS (43.6% vs 38.5%, p=0.15) | Comparable 5-year DFS (52.4% vs 41.7%, p=0.09) | None | Increased (22.4% vs 7.3%, p=0.001) |
| Zhong et al20 | 2021 | Retrospective -PSM | N/a | Comparable 5-year OS (56.4% vs 53.1%, p=0.6) | Increased 5-year DFS (25.5% vs 16%, p<0.001) | Comparable (0.9% vs 0.4%, p=1) | Increased (19 vs 5.3, p<0.001) |
| Wei et al31 | 2021 | Retrospective -PSM | Early disease (BCLC 0/A | Comparable 5-year OS (59% vs 71.4%, p=0.36) | Comparable 5-year DFS (32.4% vs 34%, p=0.78) | N/a | Comparable (p=0.62) |
| Feng et al57 | 2020 | Retrospective -PSM | Up to three nodules, ≤5 cm | Comparable 5-year OS (38.1% vs 55.6%, p=0.11) | Comparable 5-year DFS (14.6% vs 19.2%, p=0.78) | None | Increased (9.1% vs 0.5%, p<0.001) |
| Lu et al61 | 2020 | Retrospective -PSM | None | Increased 5-year PRS (71.8% vs 41.7%, p=0.002) | N/a | None | N/a |
| Salvage liver resection after previous radiofrequency ablation vs repeat hepatectomy after previous liver resection | |||||||
| Yamashita et al62 | 2015 | Retrospective | N/a | Decreased 5-year OS (52%, p=0.02) | Decreased 3-year DFS (p=0.02) | None | Increased (26% vs 4%, p<0.1) |
| Yamagishi et al63 | 2019 | Retrospective | N/a | Decreased 5-year OS (41.8% vs 63.2%, p=0.02) | Comparable 5-year DFS rate (10.3% vs 15.9%, p=0.4) | Comparable (1.8% vs 0, p=1) | Comparable (27.7% vs 31.4%, p=0.83) |
| Salvage liver transplantation versus repeat resection | |||||||
| Ma et al69 | 2018 | Retrospective -PSM | UCSF | Increased 5-year OS (71.6% vs 32.8%, p<0.001) | Increased 5-year DFS (72.8% versus 48.3%, p=0.007) | Comparable (0 vs 1.9%, p>0.99) | Comparable (16% vs 8.3%, p=0.21) |
| Chan et al68 | 2013 | Retrospective | Within Milan criteria | Increased 5-year OS (60% vs 48%, p=0.004) | Increased 5-year DFS (57.9% versus 49.3%, p<0.001) | N/a | N/a |
| RFA vs TACE | |||||||
| Wang et al54 | 2020 | Retrospective | Tumor size ≤3 cm, ≤3 tumors | Comparable 3-year OS (68.8% vs 45%, p=0.49) | Increased 3-year PFS (p=0.004) | None | None |
| Gou et al53 | 2022 | Meta-analysis | N/a | Increased odds for 5-year OS (OR=3.22, 95% CI=1.34–7.72, p=0.009) | N/a | N/a | Comparable (OR=1.78, 95% CI=0.55–5.78, p=0.33) |
Abbreviations: RFA, radiofrequency ablation; TACE, transarterial chemoembolization; OS, overall survival; DFS, disease-free survival; OR, odds ratio; CI, confidence interval; RCT, randomized controlled trial; PSM, propensity-score matching; BCLC, Barcelona Clinic Liver Cancer staging system.