A Systematic Review Of The Efficacy And Safety Of Radiofrequency Ablation Plus Transcatheter Arterial Chemoembolization For Hepatocellular Carcinoma

Objective:To evaluate the efficacy and safety of radiofrequencyablation (RFA) plus transcatheter arterial chemoembolization(TACE) totreat hepatocellular carcinoma（HCC）.Methods: PubMed (1978-2014), Cochrane library (1978-2014),EMBase (1978-2014) and CNKI (1978-2014) were searched forrandomized controlled trials on the efficacy of comparing RFA plus TACEwith RFA alone for HCC.Results:According to the inclusion criteria, nine studies wereselected. Meta-analysis data revealed that RFA plus TACE hadsignificantly better effectiveness on1-,3-and5-year overall survival rate(OR1-y=2.34,95%CI:1.54-3.57,P＜0.0001; OR3-y=1.99,95%CI:1.43-2.77, P＜0.0001; OR5-y=2.26,95%CI:1.03-4.95, P=0.04) and1-,3-year recurrence-free survival rate (OR1-y=1.74,95%CI:1.16-2.63,P=0.008; OR3-y=2.47,95%CI:1.61-3.80, P＜0.0001) than that of RFA alone treatment. There was no difference in terms of major complications(OR=1.24,95%CI:0.79-1.95, P=0.36). Subgroup analyses by tumorsize showed that RFA plus TACE significantly improved the overallsurvival rates at1and3years compared with RFA alone in patients withHCC between3cm and5cm.Conclusions:The combination of RFA with TACE can significantlyimprove the recurrence-free survival and overall survival of patients withHCC relative to RFA monotherapy, especially for those with HCCbetween3cm and5cm.