OBJECTIVETo evaluate the therapeutic effects of transcatheter arterial chemoembolization (TACE) with or without radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients based on propensity score matching.

METHODSA logistic regression model was established with the treatment assignment as the dependent variable and the covariates as the independent variables. For each HCC patient, the propensity score was calculated from the model for caliper matching, and a survival analysis of the matched data were carried out.

RESULTSThe covariates between the groups were balanced after caliper matching based on the propensity scores. Before matching, the one-, two-, and three-year survival rates of TACE and TACE+RFA were 52.07% and 59.08%, 32.24% and 36.43%, and 316.54% and 19.39%, with the median survival time of 1.20 and 1.40 years, respectively, showing no significant differences in the overall survival rate between the two groups. After matching, the 1-year, 2-year, and 3-year survival rates of TACE and TACE+RFA groups were 54.39% and 62.28%, 23.15% and 40.08%, and 10.20% and 18.52%, with the median survival time of 1.10 years and 1.50 years, respectively, showing significant differences in the overall survival between the two groups. The survival rate in TACE+RFA group was higher than that of TACE only group.

CONCLUSIONPropensity score matching can effectively reduce the confounding bias of non-randomized clinical observational data for a more accurate evaluation of the therapeutic effect in HCC patients.