Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis
Background Transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), and microwave ablation (MWA) are regarded as effective therapies for treating unresectable hepatocellular carcinoma (HCC). We conducted this study to compare the efficiency and safety of TACE combined with RFA...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Taylor & Francis Group
2020-01-01
|
Series: | International Journal of Hyperthermia |
Subjects: | |
Online Access: | http://dx.doi.org/10.1080/02656736.2020.1774667 |
id |
doaj-645fede1a26f44a4bd491b158253c924 |
---|---|
record_format |
Article |
spelling |
doaj-645fede1a26f44a4bd491b158253c9242021-08-09T15:50:02ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572020-01-0137162463310.1080/02656736.2020.17746671774667Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysisJiani Zhao0Jianxin Wu1Mengyu He2Menghao Cao3Jun Lei4Hongliang Luo5Fengming Yi6Jingli Ding7Yiping Wei8Wenxiong Zhang9Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Digestive Oncology, The Second Affiliated Hospital of Nanchang UniversityDepartment of Gastroenterology, The Second Affiliated Hospital of Nanchang UniversityDepartment of Thoracic Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Thoracic Surgery, The Second Affiliated Hospital of Nanchang UniversityBackground Transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), and microwave ablation (MWA) are regarded as effective therapies for treating unresectable hepatocellular carcinoma (HCC). We conducted this study to compare the efficiency and safety of TACE combined with RFA (TR group) or MWA (TM group). Method PubMed, the Cochrane Library, Ovid Medline, Web of Science, Scopus, Embase, ScienceDirect, and Google Scholar were searched. The primary endpoints were overall survival (OS), progression-free survival (PFS), response rates, and complications. Result Eight cohort studies and one randomized controlled trial were included. The TM group had better OS (Hazard ratio [HR]: 1.55; 95% confidence interval [CI]: 1.09–2.21, p = 0.01) and a better 2- and 3-year OS rate, 24-month PFS rate (Risk ratio [RR]: 0.67; 95% CI: 0.46–0.96, p = 0.03), and complete response rate (RR: 0.87; 95% CI: 0.79–0.96, p = 0.003) than the TR group. Furthermore, the TM and TR groups did not show significant differences in PFS, the disease control rate or complications. The advantage of TM was mainly reflected in younger patients (50–60 years old) compared with patients aged 60–70 years, as well as in patients with larger tumors (≥3 cm) compared with patients with tumors <3 cm. Moreover, patients treated with conventional TACE (cTACE) in the TM group showed longer OS, while patients treated with drug-eluting bead transarterial chemoembolization (DEB-TACE) in the TR group showed a higher overall response rate. Conclusion TM seems to be a more effective therapy than TR for unresectable HCC, with better survival and similar safety.http://dx.doi.org/10.1080/02656736.2020.1774667unresectable hepatocellular carcinomatranscatheter arterial chemoembolizationradiofrequency ablationmicrowave ablationmeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiani Zhao Jianxin Wu Mengyu He Menghao Cao Jun Lei Hongliang Luo Fengming Yi Jingli Ding Yiping Wei Wenxiong Zhang |
spellingShingle |
Jiani Zhao Jianxin Wu Mengyu He Menghao Cao Jun Lei Hongliang Luo Fengming Yi Jingli Ding Yiping Wei Wenxiong Zhang Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis International Journal of Hyperthermia unresectable hepatocellular carcinoma transcatheter arterial chemoembolization radiofrequency ablation microwave ablation meta-analysis |
author_facet |
Jiani Zhao Jianxin Wu Mengyu He Menghao Cao Jun Lei Hongliang Luo Fengming Yi Jingli Ding Yiping Wei Wenxiong Zhang |
author_sort |
Jiani Zhao |
title |
Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
title_short |
Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
title_full |
Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
title_fullStr |
Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
title_full_unstemmed |
Comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
title_sort |
comparison of transcatheter arterial chemoembolization combined with radiofrequency ablation or microwave ablation for the treatment of unresectable hepatocellular carcinoma: a systemic review and meta-analysis |
publisher |
Taylor & Francis Group |
series |
International Journal of Hyperthermia |
issn |
0265-6736 1464-5157 |
publishDate |
2020-01-01 |
description |
Background Transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA), and microwave ablation (MWA) are regarded as effective therapies for treating unresectable hepatocellular carcinoma (HCC). We conducted this study to compare the efficiency and safety of TACE combined with RFA (TR group) or MWA (TM group). Method PubMed, the Cochrane Library, Ovid Medline, Web of Science, Scopus, Embase, ScienceDirect, and Google Scholar were searched. The primary endpoints were overall survival (OS), progression-free survival (PFS), response rates, and complications. Result Eight cohort studies and one randomized controlled trial were included. The TM group had better OS (Hazard ratio [HR]: 1.55; 95% confidence interval [CI]: 1.09–2.21, p = 0.01) and a better 2- and 3-year OS rate, 24-month PFS rate (Risk ratio [RR]: 0.67; 95% CI: 0.46–0.96, p = 0.03), and complete response rate (RR: 0.87; 95% CI: 0.79–0.96, p = 0.003) than the TR group. Furthermore, the TM and TR groups did not show significant differences in PFS, the disease control rate or complications. The advantage of TM was mainly reflected in younger patients (50–60 years old) compared with patients aged 60–70 years, as well as in patients with larger tumors (≥3 cm) compared with patients with tumors <3 cm. Moreover, patients treated with conventional TACE (cTACE) in the TM group showed longer OS, while patients treated with drug-eluting bead transarterial chemoembolization (DEB-TACE) in the TR group showed a higher overall response rate. Conclusion TM seems to be a more effective therapy than TR for unresectable HCC, with better survival and similar safety. |
topic |
unresectable hepatocellular carcinoma transcatheter arterial chemoembolization radiofrequency ablation microwave ablation meta-analysis |
url |
http://dx.doi.org/10.1080/02656736.2020.1774667 |
work_keys_str_mv |
AT jianizhao comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT jianxinwu comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT mengyuhe comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT menghaocao comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT junlei comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT hongliangluo comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT fengmingyi comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT jingliding comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT yipingwei comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis AT wenxiongzhang comparisonoftranscatheterarterialchemoembolizationcombinedwithradiofrequencyablationormicrowaveablationforthetreatmentofunresectablehepatocellularcarcinomaasystemicreviewandmetaanalysis |
_version_ |
1721213761868529664 |