Radiofrequency Ablation Combined with Transcatheter Arterial Chemoembolization Therapy Versus Surgical Resection for Hepatocellular Carcinoma within the Milan Criteria: A Meta-Analysis.
10.3348/kjr.2018.19.4.613
- Author:
Wei dong WANG
1
;
Li hua ZHANG
;
Jia Yan NI
;
Xiong ying JIANG
;
Dong CHEN
;
Yao ting CHEN
;
Hong liang SUN
;
Jiang hong LUO
;
Lin feng XU
Author Information
1. Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China. xu_linfeng0216@163.com
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Radiofrequency ablation;
Transarterial chemoembolization;
Surgical resection;
Hepatocellular carcinoma;
Meta-analysis
- MeSH:
Carcinoma, Hepatocellular*;
Case-Control Studies;
Catheter Ablation*;
Humans;
Length of Stay;
Odds Ratio;
Survival Rate
- From:Korean Journal of Radiology
2018;19(4):613-622
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To meta-analytically compare combined transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) and surgical resection (SR) for the treatment of hepatocellular carcinoma (HCC) within the Milan criteria. MATERIALS AND METHODS: PubMed, Medline, Embase, and Cochrane Library were searched for studies comparing these two therapies that were published between January 2006 and August 2017. Overall survival rate (OS), recurrence-free survival rate (RFS), major complications and the average length of hospital stay were compared between these two therapies. Meta-analytic pooled odds ratio (OR) was calculated using TACE plus RFA as the base category. RESULTS: Seven case-control studies and one randomized trial were identified. Meta-analytic results revealed that, compared with SR, TACE plus RFA had significantly higher 1-year OS (OR for survival = 0.50, p = 0.009) and lower major complications (OR = 1.88, p = 0.02) after therapy. Three studies reported on the length of hospital stay. The average length ± standard deviation reported in individual studies for SR and TACE plus RFA groups was 19.8 ± 8.4 days and 7.4 ± 2.2 days, respectively; 18.7 ± 4.9 days and 11.5 ± 6.9 days, respectively; and 16.6 ± 6.7 days and 8.5 ± 4.1 days, respectively (p < 0.0001 for all studies). Three or 5-year OS and 1-, 3-, or 5-year RFS did not significantly differ between the two therapies. CONCLUSION: Combined TACE plus RFA may be an alternative to SR for the treatment of patients with HCC within Milan the criteria. Non-randomized design in most of the original studies was a limitation.
