Combination of Transarterial Chemoembolization (TACE) and Radiofrequency Ablation (RFA) vs. Surgical Resection (SR) on Survival Outcome of Early Hepatocellular Carcinoma: A Meta-Analysis.

Although TACE-RFA combination presented synergetic effect over monotherapy in patients with early HCC, whether it can achieve comparable survival outcome as surgical resection is still not clear. This study tried to pool previous studies to assess the survival outcome of TACE-RFA versus SR alone in early HCC patients with resectable small tumor. Four retrospective studies were included in this study. Pooled analysis showed that TACE-RFA provides comparable one and three year three overall survival (OS) rate and one year recurrence free survival (RFS) rate to surgical resection (SR) in the patients. However, this combination is associated with significantly lower three year RFS rate compared with SR. As to surgical complications, TACE-RFA group had significantly lower risk of major complications. Therefore, SR should still be considered as the primary choice for early HCC patients. But surgical complications should also be considered when deciding surgical procedures. Future large RCTs are required to confirm the findings of this study.