Influence of transarterial chemoembolization combined radiofrequency ablation and surgical resection on survival rate in patients with early hepatocellular carcinoma:a Meta analysis / 重庆医学

ABSTRACT

Objective To evaluate the effectiveness and safety of transarterial ehemoembolization(TACE) combined with radiofrequency ablation(RFA) and surgical resection(SR) in the treatment of early stage hepatocellular carcinoma(HCC).Methods PubMed,Medline,Embase,China biomedical database,Wanfang database,CQVIP database and Chinese Journal Full-text database were retrieved by computer.Prospective or retrospective studies of TACE combined with RFA and SR for treating early HCC published from January 2000 to March 2016 were collected.Results Four randomized or non-randomized concurrent controlled trials were included,involving 697 patients.The 1-year and 3-year overall survival(OS) rates in the TACE-RFA group were[94.40％(337/357) and 59.94％(214/357),which in the SR group were 92.35％(314/340) and 68.24％ (232/340),the difference between the two groups was not statistically significant(OR=1.43,95％CI0.79-2.60,P=0.24,I2 =0％;OR=0.77,95％CI0.56-1.07,P=0.12,I2 =45％).The 1-year relapse-free survival(RFS) rate of the TACE-RFA group and the SR group was similar [81.5％(291/357) vs.80.3％(273/340),OR=1.07,95％CI0.73-1.57,P=0.74,I2=0％],while the 3-year RFSrate of the TACE-RFA group was obviously lower than that of the SR group(29.97％ vs.44.41％,OR=0.56,95％CI0.40-0.77,P=0.000 5,I2 =0％).The incidence rate of severe complications in the TACE-RFA group was evidently lower than that in the SR group(1.43％ vs.5.07％,OR=0.23,95％CI0.10-0.54,P=0.000 7,I2 =10％).Conclusion Compared with TACE-RFA,SR can significantly reduce the long term recurrence rate of early stage HCC,but the occurrence rate of severe complications in SR is higher than that in TACE-RFA.