ABSTRACT
To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.
ABSTRACT
To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.
Subject(s)
Humans , Carcinoma, Hepatocellular , Mortality , Therapeutics , Catheter Ablation , Methods , Chemoembolization, Therapeutic , Methods , Combined Modality Therapy , Liver Neoplasms , Mortality , Therapeutics , Randomized Controlled Trials as Topic , Survival Analysis , Survival Rate , Treatment OutcomeABSTRACT
A total of1415 elderly individuals in Nanchang were included in the study and were divided into normal glucose tolerance group, impaired glucose regulation group, and diabetes mellitus group.The results showed that HbA1C was significantly correlated with fasting plasma glucose (FPG) and 2 h postprandial plasma glucose.When HbA1C 6.3% was applied as the cut point of diabetes, the sensitivity was 85.19% and the specifity was 99.45%.When HbA1C 6.5% was applied, the sensitivity was 75.56% and specifity was 99.61%.It seems that HbA1C 6.3% had higher specifity and sensitivity for diagnosing diabetes than HbA1C 6.5% and FPG 7.0mmol/L in studied population.