Efficacy and safety of radiofrequency ablation plus transcatheter arterial chemoembolization for hepatocellular carcinoma：a systematic review

Abstract:

Objective：To evaluate the efficacy and safety of radiofrequency ablation（RFA） plus transcatheter arterial chemoemboliza－tion（TACE） in the treatment of hepatocellular carcinoma（HCC）. Methods：PubMed（1978-2013），Cochrane library（1978-2013），EMBase（1978-2013） and CNKI（1978-2013） were searched for randomized controlled trials comparing efficacy of RFA plus TACE and RFA alone for HCC. Results：According to the inclusion criteria，nine studies were selected. Meta analysis data revealed that RFA plus TACE treatment had significantly better effectiveness on 1，3，5-year overall survival rate（OR1 year=2.34，95%CI=1.54 to 3.57，P=0.000；OR3 years=1.99，95%CI=1.43 to 2.77，P=0.000；OR5 years=2.26，95%CI=1.03 to 4.95，P=0.040） and 1，3-year recurrence free sur－vival rate（OR1 year=1.74，95%CI=1.16 to 2.63，P=0.008；OR3 years=2.47，95%CI=1.61 to 3.80，P=0.000） than those of RFA alone treatment. There was no difference in terms of major complications（OR=1.24，95%CI=0.79 to 1.95，P=0.360）. Subgroup analyses by tumor size showed that 1，3-year overall survival rate was significantly improved in RFA plus TACE treatment than in RFA alone treatment in patients with HCC between 3 cm and 5 cm. Conclusion：Combination of RFA with TACE can significantly improve the recurrence free survival and overall survival of patients with HCC，especially for those with HCC between 3 cm and 5 cm.