Wang Weidong, Hou Sinan, Zhong Zelong, Ni JiaYan, Jiang Xiongying, Chen Dong, Chen Yaoting, Luo Jianghong, Sun Hongliang, Xu Linfeng
Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. No. 107 Yanjiang Road West, Guangzhou 510120, Guangdong Province, China.
J Interv Med. 2019 Apr 30;1(1):49-57. doi: 10.19779/j.cnki.2096-3602.2018.01.10. eCollection 2018 Feb.
The objective of our study was to compare the effectiveness of the combination of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) with that of surgical resection (SR) in Barcelona-Clinic Liver Cancer (BCLC) A hepatocellular carcinoma. PubMed, Medline, Embase, and Cochrane Library were searched for comparisons of the two therapies from January 2006 to December 2017. Overall survival rate (OS), recurrence-free survival rate (RFS), complications, and the average length of hospital stay were compared and analyzed. Review Manager v. 5.2 from the Cochrane Collaboration was used for statistical analyses. Seven case-control studies and one randomized controlled trial were identified, of which 717 were treated with a combination of TACE and RFA and 785 were treated with SR. Meta-analysis data revealed that TACE plus RFA had significantly better effectiveness on 1.0-y OS (OR = 0.50, p = .009). The major complications (ORcomplications = 1.88, p = .02) after the combined therapy were significantly lower than those after SR. There were three studies that reported the average length of hospital stay. The hospital stay for the SR group vs the combined therapy group was 19.8 ± 8.4 d vs 7.4 ± 2.2 d, respectively (p < .0001); 18.7 ± 4.9 d vs 11.5 ± 6.9 d, respectively (p < .0001); and 16.6 ± 6.7 d vs 8.5 ± 4.1 d, respectively (p < .0001). There was no significant difference in 3.0- or 5.0-y OS and 1.0-, 3.0-, or 5.0-y RFS. The combination of TACE and RFA has advantages in improving 1.0-y OS, reducing complications, and shortening the length of hospital stay over that of SR in the treatment of patients with BCLC A HCC.
我们研究的目的是比较经动脉化疗栓塞术（TACE）联合射频消融术（RFA）与手术切除（SR）治疗巴塞罗那临床肝癌（BCLC）A期肝细胞癌的疗效。检索了PubMed、Medline、Embase和Cochrane图书馆，以获取2006年1月至2017年12月这两种疗法的比较资料。比较并分析了总生存率（OS）、无复发生存率（RFS）、并发症及平均住院时间。采用Cochrane协作网的Review Manager v. 5.2进行统计分析。共纳入7项病例对照研究和1项随机对照试验，其中717例接受TACE联合RFA治疗，785例接受SR治疗。Meta分析数据显示，TACE联合RFA在1年总生存率方面疗效显著更好（OR = 0.50，p = 0.009）。联合治疗后的主要并发症（OR并发症 = 1.88，p = 0.02）显著低于SR术后。有3项研究报告了平均住院时间。SR组与联合治疗组的住院时间分别为19.8±8.4天和7.4±2.2天（p < 0.0001）；分别为18.7±4.9天和11.5±6.9天（p < 0.0001）；分别为16.6±6.7天和8.5±4.1天（p < 0.0001）。3年或5年总生存率以及1年、3年或5年无复发生存率无显著差异。在治疗BCLC A期肝癌患者时，TACE联合RFA在提高1年总生存率、减少并发症及缩短住院时间方面优于SR。
