Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: A systematic review and meta-analysis

Background: To determine whether the use of radiofrequency ablation (RFA) plus transcatheter arterial chemoembolization (TACE) is more effective than the use of RFA alone for patients with hepatocellular carcinoma (HCC). Methods: A computer-based search was performed. Randomised trials comparing RFA plus TACE and RFA alone for treatment of HCC were included in this meta-analysis. The outcome of interest for our analysis was survival (recurrence-free survival and overall survival). Results: Eight trials with 648 patients were eligible for this meta-analysis. Our pooled results suggest that RFA plus TACE is associated with a significant advantage in recurrence-free survival (RFS) (HR = 0.58; 95% CI = 0.42-0.80, P = 0.001), and overall survival (OS) (HR = 0.60; 95% CI = 0.47-0.76, P < 0.001). Conclusion: TACE combined with RFA was more effective than RFA alone, especially for treatment for intermediate and large-size hepatic tumours or younger patients with HCC. (C) 2015 Elsevier Masson SAS. All rights reserved.