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Review

A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma

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Pages 450-462 | Received 28 Mar 2018, Accepted 29 Jul 2018, Published online: 25 Oct 2018

Figures & data

Figure 1. PRISMA-NMA diagram of the literature search evaluating interventional RCTs for early-stage HCC through a selection process. Studies were identified from PubMed, Embase, Cochrane Library and Clinicaltrial.gov databases. There were 1202 references identified from the databases and a total of 35 RCTs were included in this study.

Figure 1. PRISMA-NMA diagram of the literature search evaluating interventional RCTs for early-stage HCC through a selection process. Studies were identified from PubMed, Embase, Cochrane Library and Clinicaltrial.gov databases. There were 1202 references identified from the databases and a total of 35 RCTs were included in this study.

Figure 2. Network plot of enrolled studies. The number labeled beside each line is the number of studies comparing these two intervention therapies.

Figure 2. Network plot of enrolled studies. The number labeled beside each line is the number of studies comparing these two intervention therapies.

Figure 3. Quality assessment of included studies using Cochrane Collaboration’s tool. (A) Overall and (B) study-level risk of bias were assessed in these seven aspects.

Figure 3. Quality assessment of included studies using Cochrane Collaboration’s tool. (A) Overall and (B) study-level risk of bias were assessed in these seven aspects.

Table 1. Baseline characteristics of included studies.

Figure 4. Network meta-analysis for analysing the rate of different interventional treatments on LTP at 1, 2, 3 and longer than 3 years. (A) Network plots of the included studies and the connections among them. The four panels indicate the subgroup analysis of LTP at 1, 2, 3 and longer than 3 years. Abbreviations: RFA: radiofrequency ablation; MWA: microwave ablation; PEI: percutaneous ethanol injection; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on LTP compared with RFA, using risk ratio (RR) values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same as in (A). The dark bars indicate the high probability of being the best interventional arms, whereas the light bars suggest being the worst arms in this outcome.

Figure 4. Network meta-analysis for analysing the rate of different interventional treatments on LTP at 1, 2, 3 and longer than 3 years. (A) Network plots of the included studies and the connections among them. The four panels indicate the subgroup analysis of LTP at 1, 2, 3 and longer than 3 years. Abbreviations: RFA: radiofrequency ablation; MWA: microwave ablation; PEI: percutaneous ethanol injection; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on LTP compared with RFA, using risk ratio (RR) values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same as in (A). The dark bars indicate the high probability of being the best interventional arms, whereas the light bars suggest being the worst arms in this outcome.

Figure 5. Network meta-analysis for analysing the rate of different interventional treatments on total recurrence at 1, 2, 3 and longer than 3 years. (A) Network plots of the included studies and the connections among them. The four panels indicate the subgroup analysis of total recurrence at 1, 2, 3 and longer than 3 years. Abbreviations: MWA: microwave ablation; PEI: percutaneous ethanol injection; RFA: radiofrequency ablation; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on total recurrence rates compared with RFA, using risk ratio (RR) values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same in (A).

Figure 5. Network meta-analysis for analysing the rate of different interventional treatments on total recurrence at 1, 2, 3 and longer than 3 years. (A) Network plots of the included studies and the connections among them. The four panels indicate the subgroup analysis of total recurrence at 1, 2, 3 and longer than 3 years. Abbreviations: MWA: microwave ablation; PEI: percutaneous ethanol injection; RFA: radiofrequency ablation; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on total recurrence rates compared with RFA, using risk ratio (RR) values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same in (A).

Figure 6. Network meta-analysis for analysing the rate of different interventional treatments on overall, disease-free and LTP-free survival rates. (A) Network plots of the included studies and the connections among them in the comparison of survival rates. The three panels indicate the analyses of overall survival rates at 1, 2, 3 and longer than 3 years. Abbreviations: MWA: microwave ablation; PEI: percutaneous ethanol injection; RFA: radiofrequency ablation; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on overall survival, disease-free survival and LTP-free survival rates compared with RFA, using HR values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same in (A).

Figure 6. Network meta-analysis for analysing the rate of different interventional treatments on overall, disease-free and LTP-free survival rates. (A) Network plots of the included studies and the connections among them in the comparison of survival rates. The three panels indicate the analyses of overall survival rates at 1, 2, 3 and longer than 3 years. Abbreviations: MWA: microwave ablation; PEI: percutaneous ethanol injection; RFA: radiofrequency ablation; TACE: transcatheter arterial chemoembolization. (B) The relative forest plots of different interventional arms on overall survival, disease-free survival and LTP-free survival rates compared with RFA, using HR values and 95% credible intervals (CrIs). (C) The results of treatment ranks using R-software. The abbreviations were the same in (A).