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Combined radiofrequency ablation or microwave ablation with transarterial chemoembolization can increase efficiency in intermediate-stage hepatocellular carcinoma without more complication: a systematic review and meta-analysis.
- Source :
-
International Journal of Hyperthermia . 2022, Vol. 39 Issue 1, p455-465. 11p. - Publication Year :
- 2022
-
Abstract
- Objectives: Radiofrequency ablation (RFA) and microwave ablation (MWA) are widely used in combination with transarterial chemoembolization (TACE) for intermediate-stage hepatocellular carcinoma (HCC) in clinical practice. We aim to compare the efficacy and safety of TACE combined with RFA or MWA versus TACE monotherapy for intermediate-stage HCC. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies. The outcomes included overall survival (OS), progression-free survival (PFS), local tumor control (LTC) rate, and major complication. Subgroup analysis for different TACE combination therapies was performed. Results: Ten studies with 1799 patients with intermediate-stage HCC were included. The pooled hazard ratio (HR) for OS was in favor of TACE combination therapy (HR, 0.50, 95% confidence interval [CI], 0.40–0.62). Specifically, the TACE combination therapy was associated with higher 1-, 3-, and 5-year OS rates. Regarding tumor progression, the TACE combination therapy showed significantly better PFS (HR, 0.47, 95% CI, 0.37–0.61) and higher 1-, 2- and 3-year PFS rates than TACE monotherapy. The pooled odds ratio (OR) for the LTC was also in favor of TACE combination therapy (OR, 0.36, 95% CI, 0.24–0.53). No significant difference was found between the two groups regarding the major complication rate (OR, 1.26, 95% CI, 0.74–2.16). These results were consistent across subgroups of TACE þ RFA versus TACE and TACE þ MWA versus TACE. Conclusion: TACE combined with RFA or MWA can provide significantly better OS, PFS and LTC than TACE monotherapy for patients with intermediate-stage HCC, without increasing the risk of major complications. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 02656736
- Volume :
- 39
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- International Journal of Hyperthermia
- Publication Type :
- Academic Journal
- Accession number :
- 161494346
- Full Text :
- https://doi.org/10.1080/02656736.2022.2048095