Interventional treatmeant for unresectable hepatocellular carcinoma: a systematic review and Meta-analysis

doi:10.3877/cma.j.issn.1674-0793.2011.01.019

Abstract

Abstract:

Objective

To compare the therapeutic effects of transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation(RFA) to TACE or RFA alone for unresectable hepatocellular carcinoma (UHCC).

Methods

All data of patients with UHCC underwent TACE+RFA versus TACE or RFA in randomized-controlled clinical trials (RCT) were collected from literature by electronic searching. Meta-analysis that recommended was done for the data of 8 researches enrolled in criteria by using RevMan 4.2 software in this study. Objects were survival and rate of complete tumor necrosis.

Results

TACE+RFA group had a statistically higher rate in 1-, 2-, 3-year survival compared with that of TACE group (all P<0.01). It also had a higher rate in 1-, 2-year survival than RFA group (P=0.03, P<0.01), but not in 3-year survival (P=0.16). As to the rate of complete tumor necrosis, combined therapy was better than either monotherapy (both P<0.01).

Conclusions

The local efficacy of TACE plus RFA for UHCC is better than either monotherapy. As to the prospective efficacy combined therapy can elevate the patients’ survival rate compared with that of TACE alone and prolong patients’ 1-, 2-year survival time compared with that of RFA alone. But there is no statistic different in 3-year patients’ survival rate when TACE plus RFA compared to RFA alone.

Key words: Hepatocellular carcinoma, TACE, RFA.

Wen-zhe FAN, Jia-ping LI, Jian-yong YANG, Yu WANG, Xian-hong XIANG, He-ping LI. Interventional treatmeant for unresectable hepatocellular carcinoma: a systematic review and Meta-analysis[J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(01): 62-67.

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Figures/Tables 5

References 19

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第一作者	病例数	TACE+RFA例数	单独TACE例数	单独RFA例数	肝功能分级A/B/C^*	病灶数	肿瘤最大直径（Mean±Sd，cm）	随访时间	分组方法	质量记分
Wang ^[8]	83	43	40	无	66/17/0	未提	未提	未提	随机	2
姬统理^[9]	56	28	28	无	26/30/0	未提	未提	>3年	随机	3
靳殿功^[10]	55	25	30	无	52/13/0	未提	T+R：6.4±2.4	未提	随机	2
靳殿功^[10]	55	25	30	无	52/13/0	未提	T：6.3±1.8	未提	随机	2
Shibata^[11]	89	46	无	43	未提	未提	<3.0	68月	随机	2
李增才^[12]	237	168	无	69	未提	未提	未提	未提	随机	1
Yang^[13]	47	24	11	12	29/16/2	单病灶20例，>2个病灶53例	T+R：6.7±1.1	未提	随机	2
							T：6.8±1.3
							R：6.2
康春博^[14]	58	19	21	18	36/22/0	单病灶42例，>2个病灶16例	T+R：6.7±1.1	>3年	随机	1
							T：6.8±1.3
							R：6.2
唐树尧^[15]	39	10	20	9	未提	未提	T+R：7.0	>3年	随机	1
							T：6.8
							R：3.2

第一作者	病例数	TACE+RFA例数	单独TACE例数	单独RFA例数	肝功能分级A/B/C^*	病灶数	肿瘤最大直径（Mean±Sd，cm）	随访时间	分组方法	质量记分
Wang ^[8]	83	43	40	无	66/17/0	未提	未提	未提	随机	2
姬统理^[9]	56	28	28	无	26/30/0	未提	未提	>3年	随机	3
靳殿功^[10]	55	25	30	无	52/13/0	未提	T+R：6.4±2.4	未提	随机	2
靳殿功^[10]	55	25	30	无	52/13/0	未提	T：6.3±1.8	未提	随机	2
Shibata^[11]	89	46	无	43	未提	未提	<3.0	68月	随机	2
李增才^[12]	237	168	无	69	未提	未提	未提	未提	随机	1
Yang^[13]	47	24	11	12	29/16/2	单病灶20例，>2个病灶53例	T+R：6.7±1.1	未提	随机	2
							T：6.8±1.3
							R：6.2
康春博^[14]	58	19	21	18	36/22/0	单病灶42例，>2个病灶16例	T+R：6.7±1.1	>3年	随机	1
							T：6.8±1.3
							R：6.2
唐树尧^[15]	39	10	20	9	未提	未提	T+R：7.0	>3年	随机	1
							T：6.8
							R：3.2

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