Shushan Yan1, Donghua Xu, Beicheng Sun. 1. Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Abstract
BACKGROUND: Recent studies suggest that the combination of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) may have a synergistic effect for hepatocellular carcinoma (HCC). AIMS: The aim of this meta-analysis was to compare the effectiveness of combination of RFA and TACE with that of RFA alone in patients with HCC. METHODS: Randomized controlled trials and retrospective cohort studies comparing RFA plus TACE with RFA alone for HCC were included into this meta-analysis. Study quality was rated with a standardized scale and the strength of evidence was also rated by using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE system). RESULTS: Meta-analyses showed that the combination of RFA and TACE was obviously associated with higher survival rates (OR1-year = 2.06, 95 % CI 1.46-2.91, P < 0.001; OR3-year = 1.93, 95 % CI 1.18-3.15, P = 0.009; OR5-year = 1.87, 95 % CI 1.23-2.83, P = 0.003). The overall quality of the evidence was judged to be low by using the GRADE system. CONCLUSIONS: The combination of TACE with RFA can improve the overall survival rate and provides better prognosis for patients with HCC, but more randomized controlled trials using large sample sizes are needed to provide sufficient evidence.
BACKGROUND: Recent studies suggest that the combination of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) may have a synergistic effect for hepatocellular carcinoma (HCC). AIMS: The aim of this meta-analysis was to compare the effectiveness of combination of RFA and TACE with that of RFA alone in patients with HCC. METHODS: Randomized controlled trials and retrospective cohort studies comparing RFA plus TACE with RFA alone for HCC were included into this meta-analysis. Study quality was rated with a standardized scale and the strength of evidence was also rated by using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE system). RESULTS: Meta-analyses showed that the combination of RFA and TACE was obviously associated with higher survival rates (OR1-year = 2.06, 95 % CI 1.46-2.91, P < 0.001; OR3-year = 1.93, 95 % CI 1.18-3.15, P = 0.009; OR5-year = 1.87, 95 % CI 1.23-2.83, P = 0.003). The overall quality of the evidence was judged to be low by using the GRADE system. CONCLUSIONS: The combination of TACE with RFA can improve the overall survival rate and provides better prognosis for patients with HCC, but more randomized controlled trials using large sample sizes are needed to provide sufficient evidence.
Authors: Gordon H Guyatt; Andrew D Oxman; Gunn E Vist; Regina Kunz; Yngve Falck-Ytter; Pablo Alonso-Coello; Holger J Schünemann Journal: BMJ Date: 2008-04-26
Authors: William Jarnagin; William C Chapman; Steven Curley; Michael D'Angelica; Charles Rosen; Elijah Dixon; David Nagorney Journal: HPB (Oxford) Date: 2010-06 Impact factor: 3.647
Authors: Zheng-ran Li; Zhuang Kang; Jie-sheng Qian; Kang-shun Zhu; Zai-bo Jiang; Ming-sheng Huang; Shou-hai Guan; Hong Shan Journal: Nan Fang Yi Ke Da Xue Xue Bao Date: 2007-11