To perform a meta-analysis examining the efficacy of transcatheter arterial chemoembolization (TACE) alone or in combination with radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), or high-intensity focused ultrasound (HIFU) for unresectable hepatocellular carcinoma (HCC).
Medline, Embase, the Cochrane Library, and Google Scholar were searched through May 31, 2014, using the following keywords: hepatocellular carcinoma, transarterial chemoembolization, percutaneous ethanol ablation, percutaneous ethanol injection, radiofrequency ablation, and high-intensity focused ultrasound. Randomized controlled trials (RCTs) comparing 1- and 3-year mortality rates in patients with unresectable HCC receiving either TACE alone or TACE in combination with RFA, PEI, or HIFU were included. One- and 3-year survival rates were compared.
Eleven RCTs were included. The total number of patients ranged from 37 to 189, mean age ranged from 52 to 73 years, and percentage male ranged from 54% to 94%. Overall, TACE alone was associated with higher 1-year mortality than TACE combination therapies (pooled odds ratio [OR] 2.47, 95% confidence interval [CI] 1.37 to 4.43, p = 0.003). The 1-year mortality rate between TACE alone vs TACE + PEI was not different, but TACE + PEI was associated with a significantly lower 3-year mortality as compared to TACE alone (pooled OR 6.02, 95% CI 3.03 to 11.93, p<0.001). The RFA alone was associated with higher 1-year mortality compared with TACE + RFA (pooled OR 2.20, 95% CI 1.11 to 4.32, p = 0.023).
Transcatheter arterial chemoembolization in combination with percutaneous ablation therapies may improve the survival of patients with unresectable HCC.
Tumori 2016; 102(3): 301 - 310
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsLei Li, Jiangke Tian, Peng Liu, Xuan Wang, Zhenyu Zhu
- • Accepted on 08/02/2016
- • Available online on 22/03/2016
- • Published in print on 02/06/2016
This article is available as full text PDF.
- Li, Lei [PubMed] [Google Scholar] 1
- Tian, Jiangke [PubMed] [Google Scholar] 2, * Corresponding Author (email@example.com)
- Liu, Peng [PubMed] [Google Scholar] 3
- Wang, Xuan [PubMed] [Google Scholar] 4
- Zhu, Zhenyu [PubMed] [Google Scholar] 5
Intensive Care Unit, 302 Hospital of PLA, Beijing - China
Department of Ultrasonography, 302 Hospital of PLA, Beijing - China
Department of Emergency, 302 Hospital of PLA, Beijing - China
Department of Endocrinology, 302 Hospital of PLA, Beijing - China
Hepatoliliary Surgery Center, 302 Hospital of PLA, Beijing - China