Cicerone O, Mantovani S, Oliviero B, Basilico G, Corallo S, Quaretti P, Maestri M. Navigating the evidence for hepatocellular carcinoma treatment: Surgery vs radiofrequency ablation through sentiment and meta-analysis. World J Clin Oncol 2025; 16(5): 105881 [DOI: 10.5306/wjco.v16.i5.105881]
Corresponding Author of This Article
Marcello Maestri, MD, PhD, Professor, Department of General Surgery I-Liver Service, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia 27100, Italy. m.maestri@smatteo.pv.it
Research Domain of This Article
Surgery
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. May 24, 2025; 16(5): 105881 Published online May 24, 2025. doi: 10.5306/wjco.v16.i5.105881
Navigating the evidence for hepatocellular carcinoma treatment: Surgery vs radiofrequency ablation through sentiment and meta-analysis
Ottavia Cicerone, Stefania Mantovani, Barbara Oliviero, Giorgia Basilico, Salvatore Corallo, Pietro Quaretti, Marcello Maestri
Ottavia Cicerone, Giorgia Basilico, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
Stefania Mantovani, Barbara Oliviero, Department of Infectious Diseases-Clinical Immunology, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Salvatore Corallo, Department of Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Pietro Quaretti, Department of Diagnostic Imaging-Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Marcello Maestri, Department of General Surgery I-Liver Service, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Author contributions: Cicerone O contributed to the concept and design of the study, the sentiment and meta-analysis and the writing of the original draft; Maestri M contributed to the concept and design, the sentiment and meta-analysis, the project administration and the supervision of the study; Mantovani S, Oliviero B, Basilico G, and Corallo S contributed to data curation; Quaretti P and Maestri M contributed to the supervision of the study; Mantovani S and Maestri M contributed to the review and editing of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcello Maestri, MD, PhD, Professor, Department of General Surgery I-Liver Service, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia 27100, Italy. m.maestri@smatteo.pv.it
Received: February 10, 2025 Revised: March 13, 2025 Accepted: April 8, 2025 Published online: May 24, 2025 Processing time: 100 Days and 5.9 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) is among the most aggressive primary liver cancers, leading to significant global mortality. While early diagnosis improves prognosis, treatment decisions, particularly between surgical resection and radiofrequency ablation (RFA), remain controversial.
AIM
To clarify this issue using sentiment analysis of medical literature alongside a meta-analysis of overall survival (OS).
METHODS
We included studies comparing liver resection and RFA, excluding case reports, editorials, and studies without relevant outcomes. A systematic search in PubMed and Web of Science identified 197 studies. Abstracts underwent sentiment analysis using Python’s Natural Language Toolkit library, categorizing them as favoring resection, ablation, or neutral. We also performed a meta-analysis using a random-effects model on 11 studies reporting hazard ratios (HRs) for OS.
RESULTS
Sentiment analysis revealed that 75.1% of abstracts were neutral, 14.2% favored resection, and 10.7% favored RFA. The meta-analysis showed a significant survival advantage for liver resection, with a pooled HR of 0.5924 (95% confidence interval: 0.540-0.649). Heterogeneity was moderate (I² = 39.98%). Despite the meta-analysis demonstrating clear survival benefits of liver resection, most abstracts maintained a neutral stance. This discrepancy highlights potential biases or hesitancy in drawing definitive conclusions.
CONCLUSION
The study emphasizes the need for clinicians to prioritize robust statistical evidence over narrative impressions. Liver resection remains the preferred treatment for HCC in eligible patients.
Core Tip: With the exponential growth of medical literature, critically evaluating content is becoming increasingly complex. Reading abstracts is often the first step in selecting articles, influencing the decision-making process of clinicians and researchers. However, this study demonstrates how such an approach can lead to misleading interpretations of actual clinical outcomes, highlighting the need for a more in-depth analysis to avoid erroneous or distorted conclusions.
