Table 1 Characteristics of included studies
Author | Region | Design | Inclusion criteria | Group | Modality of RFA | No. of patients | Age | Gender (M/F) | HBV/HCV | Child–Pugh A/B | AFP (ng/ml) | Tumor size (cm) | Solitary/multiple | 100% AR/NAR | 100% LH (Y/N) | Resection margin | Ablation margin | Follow-up (months) | Survival (median (95% CI)) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Zhang | China | PSM | Single tumor; ≤ 3 cm | LR |  | 67 | 57.51 ± 8.37 | 50/17 | 56/6 | 67/0 | 189.00 ± 568.99 | 24.67 ± 5.97* | 67/0 | AR | NR |  > 1 cm |  | 96ψ | mOS: not reached mRFS: 47 (42–NA) |
2022 |  |  |  | RFA | Ultrasound guided or laparoscopic | 67 | 57.78 ± 10.97 | 49/18 | 56/7 | 67/0 | 258.39 ± 578.19 | 24.2 8 ± 5.73* | 67/0 |  |  |  |  > 1 cm | 96ψ | mOS: 95 (79–NA) mRFS: 33 (26–51) |
Takayama | Japan | RCT |  ≤ 3 nodules; ≤ 3 cm | LR |  | 150 | 68 (63–74)ζ | 112/38 | 27/97 | 139/10 | NR | 1.8 (1.5–2.2)ζ | 135/15 | NR | NR | NA |  | 5.04 (0.36–9.49)η,δ | mRFS: 3.46δ |
2022 |  |  |  | RFA | Ultrasound guided | 151 | 69 (63–74)ζ | 108/43 | 33/94 | 149/2 | NR | 1.8 (1.5–2.3)ζ | 136/15 |  |  |  | NA | 4.99 (0.00–8.70)η,δ | mRFS: 3.04δ |
Liu | China | PSM |  ≤ 3 nodules; ≤ 3 cm | LR |  | 103 | 63 (55–71)ζ | 76/27 | 48/43 | 102/1 | 5(> 400) | 56 (> 20)* | 94/9 | NR | Y | NA |  | 14.5 (9.9–57.7)ζ | mOS: 73.6 mRFS: 49.5 |
2022 |  |  |  | RFA | Ultrasound guided | 103 | 63 (54–70)ζ | 75/28 | 54/42 | 102/1 | 9(> 400) | 60 (> 20)* | 89/14 |  |  |  | NA | 14.5 (9.9–57.7)ζ | mOS: 81 mRFS: 36.4 |
Ko | Korea | PSM | Single tumor; 1–3 cm | LR |  | 23 | NR | NR | NR | NR | NR | NR | 23/0 | NR | Y | NA |  | NR | NR |
2022 | Â | Â | Â | RFA | laparoscopic | 23 | NR | NR | NR | NR | NR | NR | 23/0 | Â | Â | Â | NA | NR | NR |
Kim | Korea | PSM | Single tumor; ≤ 4 cm | LR |  | 61 | 59.4ψ | 43/18 | 43/3 | 59/2 | 304.6 ± 1215.3 | 2.29 ± 0.8 | 61/0 | NR | Y | NA |  | NR | NR |
2022 |  |  |  | RFA | Ultrasound guided | 61 | 62.2ψ | 52/9 | 46/3 | 55/6 | 173.6 ± 765.6 | 2.2 ± 0.8 | 61/0 |  |  |  | NA | NR | NR |
Filippo | Italy | PSM | BCLC 0/A stage | LR |  | 22 | 82.8 ± 3.2 | 13/9 | 13/2 | 19/3 | NR | 15 (> 20)* | 20/2 | NR | NR | NA |  | NR | NR |
2022 |  |  |  | RFA | Ultrasound guided or open or laparoscopic | 22 | 82.2 ± 2.4 | 16/6 | 15/1 | 21/1 | NR | 15 (> 20)* | 20/2 |  |  |  | NA | NR | NR |
Cheng | China | PSM | BCLC 0/A stage | LR |  | 99 | 63.60 ± 9.86 | 82/17 | 82/12 | 83/2 | 47 (6.0–423.0)ζ | 2.31 ± 1.93 | 96/3 | NR | Y | NA |  | 34 (1–175)η | NR |
2022 |  |  |  | RFA | Ultrasound or CT guided | 31 | 65.48 ± 11.73 | 22/9 | 22/8 | 27/2 | 34 (3.5–242.5)ζ | 1.14 ± 0.70 | 28/3 |  |  |  |  > 1 cm | 34 (1–175)η | NR |
Li | China | PSM | Single tumor; ≤ 2 cm | LR |  | 59 | 61 (35–82)ζ | 39/19 | 28/34 | 56/2 | 5 (> 200) | 1.9 (1.0–2.0)ζ | 58/0 | NR | NR | NA |  | NR | NR |
2021 |  |  |  | RFA | NA | 59 | 61 (34–80)ζ | 39/19 | 23/27 | 57/1 | 12 (> 200) | 1.8 (1.0–2.0)ζ | 58/0 |  |  |  | NA | NR | NR |
Lee,D | Korea | PSM | Single tumor; ≤ 3 cm | LR |  | 118 | 59.5 ± 8.7 | 91/27 | 90/10 | 118/0 | 90.2 ± 309.0 | 1.84 ± 0.56 | 118/0 | NR | Y | NA |  | NR | NR |
2021 |  |  |  | RFA | Ultrasound guided | 118 | 60.5 ± 10.3 | 88/30 | 84/12 | 118/0 | 67.6 ± 173.4 | 1.87 ± 0.51 | 118/0 |  |  |  | Completed | NR | NR |
Conticchio | France and Italy | PSM | BCLC 0/A stage | LR |  | 136 | 74.7 (70–86.1)η | 104/32 | 22/68 | 116/20 | NR | 24.5 (7–50)*η | 120/16 | NR | NR | NA |  | NR | NR |
2021 |  |  |  | RFA | Ultrasound guided or open or laparoscopic | 136 | 75 (70–88)η | 98/38 | 10/73 | 114/22 | NR | 25 (10–50)*η | 117/19 |  |  |  | NA | NR | NR |
Bai 1 | China | PSM | BCLC 0/A stage | LR |  | 250 | 45 (> 60) | 212/38 | 250/0 | 226/24 | 126 (< 400) | 94 (≤ 3) | 199/51 | NR | NR |  > 0.5 cm |  | 60.5 (3.1–154.6)η | NR |
2021 |  |  |  | RFA | Ultrasound guided | 250 | 57 (> 60) | 202/48 | 250/0 | 222/28 | 144(< 400) | 106 (≤ 3) | 207/43 |  |  |  |  > 0.5 cm | 58.7 (3.3–147.5)η | NR |
Bai 2 | China | PSM | BCLC 0/A stage | LR |  | 423 | 98(> 60) | 260/55 | 423/0 | 287/28 | 368 (< 400) | 357 (≤ 3) | 411/12 | NR | NR | NA |  | 60.5 (3.1–154.6)η | NR |
2021 |  |  |  | RFA | Ultrasound guided | 423 | 101 (> 60) | 264/51 | 423/0 | 285/30 | 367(< 400) | 349 (≤ 3) | 415/8 |  |  |  | NA | 58.7 (3.3–147.5)η | NR |
Pan | China | PSM | BCLC 0/A stage | LR |  | 118 | 53.0 (45.2–61.0)ζ | 101/17 | 100/NR | NR | 22.6 (3.94–218)ζ | 2.50 (1.85–3.50)ζ | 98/20 | NR | NR | NA |  | 26.22 (1.30–44.73)η | mOS: 25.6 mRFS: 22.0 |
2020 |  |  |  | RFA | Ultrasound guided | 236 | 56.0 (45.0–64.0)ζ | 206/30 | 215/NR | NR | 8.61 (3.12–165)ζ | 2.55 (1.90–3.23)ζ | 199/37 |  |  |  | Completed | 24.20 (0.97–44.73)η | mOS: 23.4 mRFS: 13.3 |
Oh | Korea | PSM | Multiple, BCLC 0/A stage | LR |  | 31 | 56.0 (52.0–66.0)ζ | 23/8 | 27/NR | 31/0 | 12.7 (6.9–63.4)ζ | 14 (≤ 2) | 0/31 | NR | NR | NA |  | 5.8 (3.4–7.1)η | NR |
2020 |  |  |  | RFA | NA | 31 | 57.0 (50.0–66.0)ζ | 26/5 | 25/NR | 31/0 | 16.1 (6.3–127.4)ζ | 18 (≤ 2) | 0/31 |  |  |  | NA | 5.8 (3.4–7.1)η | NR |
Chong | China | PSM | BCLC 0/A stage | LR |  | 59 | 57.7 ± 10.5 | 46/13 | 48/4 | 59/0 | 71 (4.0–436)ζ | 2.0 (1.6–2.8)ζ | 56/3 | NR | Y | NA |  | NR | NR |
2020 |  |  |  | RFA | Ultrasound or CT guided or laparoscopic | 59 | 59.3 ± 11.0 | 46/13 | 48/4 | 58/1 | 15 (4.0–305.0)ζ | 2.3 (1.5–2.7)ζ | 56/3 |  |  |  | NA | NR | NR |
Ye | China | PSM | Single tumor; 3–5 cm | LR |  | 154 | 103 (> 60) | 141/13 | 135/2 | 139/15 | 78 (< 20) 29 (≥ 400) | 113 (3–4) 41 (4–5) | 154/0 | NR | NR |  |  | NR | NR |
2019 |  |  |  | RFA | Ultrasound guided | 154 | 103 (> 60) | 134/20 | 134/5 | 144/10 | 77 (< 20) 27 (≥ 400) | 111 (3–4) 43 (4–5) | 154/0 |  |  | NA |  | NR | NR |
Wang | China | PSM | Single tumor; ≤ 2 cm | LR |  | 80 | 56 (41–62) | 66/14 | 74/6 | 66/14 | 17 (3–378) | 1.8 (1.5–2.0) | 80/0 | NR | NR |  | 0.5–1.0 cm | 27ψ | NR |
2019 |  |  |  | RFA | NA | 80 | 52 (44–62) | 64/16 | 74/6 | 62/18 | 34 (6–348) | 1.7 (1.5–2.0) | 80/0 |  |  | NA |  | 27ψ | NR |
K im | Korea | PSM | Single tumor; ≤ 2 cm | LR |  | 48 | 56.2 ± 8.9 | 38/10 | 36/5 | 48/0 | 137.1 ± 255.3 | 1.57 ± 0.30 | 48/0 | NR | NR |  |  | 59.1 ± 37.3 | NR |
2019 |  |  |  | RFA | Ultrasound or CT guided | 48 | 58.7 ± 9.8 | 35/13 | 34/8 | 48/0 | 146.2 ± 280.7 | 1.53 ± 0.32 | 48/0 |  |  |  |  > 0.5 cm | 63.3 ± 30.4 | NR |
Di Sandro | Italy | PSM | BCLC 0/A stage | LR |  | 91 | 65 (62–72)ζ | NR | 15/58 | NR | 27 (≤ 5) 24 (5–22) 23 (> 22) | 20 (19–28)*ζ | 91/0 | NR | NR | NA |  | 33 (17–56)ζ | NR |
2019 |  |  |  | RFA | Percutaneous ablation | 91 | 65 (56–76)ζ | NR | 13/62 | NR | 26 (≤ 5) 26 (5–22) 26 (> 22) | 20 (17–26)*ζ | 91/0 |  |  |  | NA | 33 (17–56)ζ | NR |
Min | Korea | PSM | Multiple, BCLC A stage | LR | Â | 20 | NR | NR | NR | NR | NR | NR | 0/20 | NR | NR | NA | Â | NR | NR |
2019 |  |  |  | RFA | Ultrasound or CT guided (n = 54) or intraoperative (n = 8) | 20 | NR | NR | NR | NR | NR | NR | 0/20 | NR | NR |  |  > 0.5 cm | NR | NR |
Lee, S | Korea | PSM | Single tumor; ≤ 3 cm; perivascular | LR |  | 62 | 55.2 ± 8.6 | NR | 47/9 | NR | 28.8 (7.4–135.8)ζ | NR | 62/0 | NR | NR | NA |  | NR | NR |
2018 |  |  |  | RFA | Ultrasound guided | 62 | 56.0 ± 9.7 | NR | 49/8 | NR | 15 (5.7–73.2)ζ | NR | 62/0 |  |  |  |  > 0.5 cm | NR | NR |
Lee,H | Korea | RCT (terminated) | Single tumor; 2–4 cm | LR |  | 29 | 55.6 ± 7.9 | 23/6 | 20/3 | 29/0 | 1671.6 ± 5887.5 | 22 (≤ 3) 7 (3–4) | 29/0 | NR | NR | NA |  | NR | NR |
2018 |  |  |  | RFA | Ultrasound guided | 34 | 56.1 ± 7.4 | 24/10 | 23/4 | 34/0 | 158.7 ± 286.9 | 26 (≤ 3) 8 (3–4) | 34/0 |  |  |  | 0.5–1 cm | NR | NR |
Kato | Japan | PSM | BCLC 0/A stage | LR |  | 70 | 68 (39–79)η | 55/15 | NR | 69/1 | 13.3 (1.4–2813.3)η | 20 (9–30)*η | 59/11 | NAR | NR | NA |  | NR | mOS: 59.5 mRFS: 26.1 |
2018 |  |  |  | RFA | Ultrasound or CT guided | 70 | 70(27–85)η | 53/17 | NR | 69/1 | 12.8 (2.0–4556.4)η | 20 (6–30)*η | 60/10 |  |  |  | NA | NR | mOS: 45.4 mRFS: 16.1 |
Chong | China | PSM | BCLC 0/A stage | LR |  | 121 | 59.5 ± 9.5 | 101/20 | 110/0 | 121/0 | 31 (6–357) | 25 (20–36)*ζ | 121/0 | NR | NR | NA |  | NR | NR |
2018 |  |  |  | RFA | NA | 121 | 62.0 ± 10.0 | 95/26 | 106/0 | 121/0 | 17 (6–129) | 25 (20–35)*ζ | 121/0 |  |  |  | NA | NR | NR |
Ng | China | RCT | BCLC 0/A stage | LR |  | 109 | 55 (31–82)η | 89/20 | 99/5 | 107/2 | 58 (1–4880)η | 2.9 (1–5)η | 99/10 | NR | NR | NA |  | 93ψ | mOS: 118.8 mRFS: 39.5 |
2017 |  |  |  | RFA | Ultrasound guided | 109 | 57 (23–78)η | 86/23 | 95/0 | 104/5 | 63.5 (2–18 070)η | 2.6 (1–5)η | 90/19 |  |  |  |  > 1 cm | 93ψ | mOS: 93.5 mRFS: 23.7 |
Song | China | PSM | Single tumor; ≤ 4 cm | LR |  | 78 | 48 (44–57)ζ | 70/8 | 73/NR | 78/0 | 38.5 (6.9, 281.9)ζ | 33 (≤ 2) 45 (2–4) | 78/0 | NR | Y | NA |  | 31.2 (21.1–49.5)η | mOS: 75 (66.8–83.9) mRFS: 75 (26–51) |
2016 |  |  |  | RFA | Ultrasound guided | 78 | 48 (43–58)ζ | 70/8 | 77/NR | 76/2 | 43.0 (6.0, 181.7)ζ | 40 (≤ 2) 38 (2–4) | 78/0 |  |  |  |  > cm | 43ψ | mOS: 70 (62.9–77.9) mRFS: 75 (26–51) |
Liu | China | PSM | Single tumor; ≤ 2 cm | LR |  | 79 | 61 ± 13 | 55/24 | 46/31 | NR | 136 ± 233 | NR | 79/0 | NR | NR |  > 1 cm |  | 44ψ | NR |
2016 |  |  |  | RFA | Ultrasound guided | 79 | 63 ± 12 | 52/27 | 36/30 | NR | 127 ± 307 | NR | 79/0 |  |  |  | NA |  | NR |
He | China | PSM | BCLC 0/A stage | LR |  | 150 | 51.2 ± 12.1 | 124/26 | 150/0 | 146/4 | 29 (200–400) 121 (≥ 400) | 2.8 ± 1.0 | 138/12 | NR | NR | NA |  | 58.2ψ | NR |
2016 |  |  |  | RFA | Ultrasound guided | 109 | 52.8 ± 12.9 | 96/13 | 109/0 | 105/4 | 31 (200–400) 78 (≥ 400) | 2.6 ± 1.0 | 100/9 |  |  |  |  > 1 cm | 42.0ψ | NR |
Yune | Korea | PSM | BCLC 0/A stage | LR |  | 17 | 60.2¶ | 14/3 | 9/1 | 16/1 | 281,800¶ | 2.2¶ | NA | NAR | NR | NA |  | 41ψ | NR |
2015 |  |  |  | RFA | Ultrasound guided or laparoscopic | 17 | 64.1¶ | 11/6 | 11/2 | 16/1 | 79,500¶ | 1.8¶ | NA |  |  |  |  > 1 cm | 26ψ | NR |
Lee1 | Korea | PSM | BCLC 0/A stage | LR |  | 147 | 64 ± 10 | 110/37 | 69/40 | 147/0 | 443 ± 2036 | 126 (≤ 3) 21 (> 3) | 115/32 | NR | NR | NA |  | NR | NR |
2015 |  |  |  | RFA | NA | 147 | 64 ± 11 | 101/46 | 57/53 | 147/0 | 297 ± 1415 | 115 (≤ 3) 32 (> 3) | 121/26 |  |  |  | NA | NR | NR |
Lee2 | Korea | PSM | BCLC 0/A stage | LR |  | 48 | 62 ± 12 | 37/11 | 20/12 | 35/12 | 332 ± 951 | 38 (≤ 3) 10 (> 3) | 41/7 | NR | NR | NA |  | NR | NR |
2015 |  |  |  | RFA | NA | 48 | 67 ± 12 | 32/16 | 11/16 | 32/15 | 526 ± 1517 | 35 (≤ 3) 13 (> 3) | 38/10 |  |  |  | NA | NR | NR |
Kang | China | PSM | BCLC 0/A stage | LR |  | 99 | 54 (31–74)η | 77/22 | 83/8 | 95/4 | 15.2 (1.0–3412.2)η | 2 (1.1–3.0) | 99/0 | NAR | NR | NA |  | NR | NR |
2015 |  |  |  | RFA | Ultrasound or CT guided | 99 | 55 (32–80)η | 77/22 | 83/8 | 95/4 | 25.6 (1.0–1873)η | 1.9 (1.1–3.0) | 99/0 |  |  |  |  > 0.5 cm | NR | NR |
Jiang | China | PSM | Multiple, BCLC A stage | LR |  | 140 | 53 ± 12 | 123/17 | 129/NR | 139/1 | 91 (< 400) | 2.4 ± 0.6 | 0/140 | NR | NR | NA |  | NR | NR |
2015 |  |  |  | RFA | Percutaneous (n = 81), laparoscopic (n = 19), and open (n = 60) | 140 | 55 ± 12 | 118/22 | 121/NR | 135/5 | 105 (< 400) | 2.3 ± 0.6 | 0/140 |  |  |  | NA | NR | NR |
Fang | China | RCT | BCLC 0/A stage | LR |  | 60 | 53.5 ± 11.0 | 46/14 | 52/NR | 43/17 | 50 (> 200) | 22.8 ± 3.5* | 49/11 | NR | NR | 96.7% completed |  | NR | NR |
2014 |  |  |  | RFA | Ultrasound or CT guided | 60 | 51.4 ± 8.1 | 42/18 | 55/NR | 32/23 | 52 (> 200) | 22.1 ± 5.2* | 41/19 |  |  |  | 95% completed | NR | NR |
Pompili | Italy | PSM | Single tumor; ≤ 3 cm | LR |  | 116 | 67 (41–83)η | 87/29 | 11/78 | NR | 11 (1–9000)η | 2.3 (0.8–3.0)η | 116/0 | NR | NR | NA |  | NR | NR |
2013 |  |  |  | RFA | NA | 116 | 69 (38–85)η | 92/24 | 17/78 | NR | 20 (2–1105)η | 2.3 (1.3–3.0)η | 116/0 |  |  |  | NA | NR | NR |
Wang | China | PSM | BCLC 0 stage | LR |  | 52 | 35 (≤ 60) | 38/14 | 34/14 | NR | 11 (> 200) | NR | 52/0 | NR | NR | NA |  | 2.3 (1.5 > 3.7)ζ,δ | NR |
2012 |  |  |  | RFA | Ultrasound guided | 52 | 29 (≤ 60) | 35/17 | 32/18 | NR | 10 (> 200) | NR | 52/0 |  |  |  | NA | 2.5 (1.4–4.1)ζ,δ | NR |
Huang | China | RCT | BCLC 0/A stage | LR |  | 115 | 55.91 ± 12.68 | 85/30 | 104/6 | 106/9 | 32(> 400) | NR | 89/26 | NR | NR |  > 1 cm |  | 3.87 (0.1–)η,δ | NR |
2010 |  |  |  | RFA | Ultrasound guided | 115 | 56.57 ± 14.30 | 79/36 | 101/4 | 110/5 | 21 (> 400) | NR | 84/31 |  |  |  | 0.5–1 cm | 3.1 (0.5–5)η,δ | NR |
Chen | China | RCT | Single tumor; ≤ 5 cm | LR |  | 90 | 49.4 ± 10.9 | 75/15 | NR | 90/0 | 60 (< 200) 6 (200–399) 24 (≥ 400) | 42 (≤ 3) 48 (> 3) | 90/0 | NR | NR |  > 1 cm |  | NR | NR |
2005 |  |  |  | RFA | Ultrasound guided | 71 | 51.9 ± 11.2 | 56/15 | NR | 71/0 | 40 (< 200) 8 (200–399) 23 (≥ 400) | 37 (≤ 3) 34 (> 3) | 71/0 |  |  |  | NA | NR | NR |