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J Cancer Res Ther. 2019;15(7):1617-1623. doi: 10.4103/jcrt.JCRT_503_19.

A comparison between radiofrequency ablation combined with transarterial chemoembolization and surgical resection in hepatic carcinoma: A meta-analysis.

Author information

1
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
2
Department of Lightning Scientific Research Group, The First Clinical Medical School; Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China.
3
Department of Lightning Scientific Research Group, The Image Clinical School, Nanjing Medical University, Nanjing, China.
4
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
5
Department of Lightning Scientific Research Group, The First Clinical Medical School, Nanjing Medical University, Nanjing, China.

Abstract

Objective:

This study determined whether the effect of combination therapy for hepatic carcinoma (HCC) is comparable to surgical resection (SR). According to the guidelines of the American Association for the Study of Liver Disease, radiofrequency ablation (RFA) and SR are recommended for early HCC. However, patients treated with RFA had worse long-term survival than those who received SR. Many studies utilizing the combination therapy with RFA and transarterial chemoembolization (TACE) have reported better prognosis as compared to RFA alone.

Materials and Methods:

A comprehensive search in databases was conducted. Six retrospective studies and one cohort were enrolled in this meta-analysis. The overall survival (OS), disease-free survival (DFS), and major complications were compared between RFA plus TACE and SR. The pooled hazard ratio and 95% confidence interval (CI) were calculated and analyzed.

Results:

After comparison, no significant difference in the OS and DFS at 1 and 3 years between the combination therapy and SR was observed (OS1: pooled relative risk [RR]: 0.82, 95% CI [0.56, 1.21]; OS3: pooled RR: 1.07, 95% CI [0.82, 1.39]; DFS1: pooled RR: 0.92, 95% CI [0.58, 1.45]; DFS3: pooled RR: 1.18, 95% CI [1.00, 1.40]). SR had better clinical outcomes than combination therapy with respect to long-term survival and disease progression (OS5: pooled RR: 1.12, 95% CI [1.03, 1.23]; DFS5: pooled RR: 1.15, 95% CI [1.03, 1.28]). Major complications were reduced with combination therapy (pooled RR: 0.46, 95% CI [0.25, 0.85]).

Conclusion:

SR should remain as the first-line therapy for early HCC.

KEYWORDS:

Hepatectomy; hepatocellular carcinoma; radiofrequency ablation; transarterial chemoembolization

PMID:
31939446
DOI:
10.4103/jcrt.JCRT_503_19
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