Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials

Zaiming Lu, Feng Wen, Qiyong Guo, Hongyuan Liang, Xiaonan Mao, Hongzan Sun
European Journal of Gastroenterology & Hepatology 2013, 25 (2): 187-94

BACKGROUND: There is a continuing debate on whether transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is more effective than RFA alone in the treatment of patients with hepatocellular carcinoma (HCC). We carried out this meta-analysis of randomized-controlled trials to provide greater clarity on whether RFA plus TACE was more effective than RFA alone for HCC.

METHODS: A literature search was carried out for all possible randomized-controlled trials. The outcomes were overall survival rates and major complications. Data were abstracted using standardized forms, and an overall rating of the quality of evidence was assigned using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. We estimated summary odds ratio (OR) with its 95% confidence interval (95% CI) to assess the effects.

RESULTS: Seven randomized-controlled trials were included. Meta-analysis showed that RFA plus TACE significantly improved the survival rates of patients with HCC at 1 and 3 years (for the one-survival rate, fixed-effects OR=2.71, 95% CI 1.65-4.43, P<0.0001; for the three-survival rate, fixed-effects OR=2.27, 95% CI 1.57-3.27, P<0.0001) compared with RFA alone. There was no difference in terms of major complications (fixed-effects OR=1.26, 95% CI 0.33-4.77, P=0.73). Subgroup analyses by tumor size showed that RFA plus TACE significantly improved the survival rates at 1, 3, and 5 years compared with RFA alone in patients with HCC larger than 3 cm; however, there was no advantage of TACE plus RFA over RFA alone for patients with HCC smaller than 3 cm. The quality of evidence was high for the 1-year survival rate, the 3-year survival rate, and major complications. No evidence of publication bias was observed.

CONCLUSION: High-quality evidence suggests that TACE plus RFA improve the survival rates compared with RFA alone for patients with HCC larger than 3 cm.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"