Treatment outcomes of transcatheter arterial chemoembolization combined with local ablative therapy versus monotherapy in hepatocellular carcinoma: a meta-analysis.
OBJECTIVE
To evaluate the effectiveness comparing the combination of TACE with local ablative therapy and monotherapy on the treatment of HCC using meta-analytical techniques.


METHODS
Randomized controlled trials and clinical studies comparing TACE plus local ablative therapy with monotherapy for HCC were included in this meta-analysis. Response rate, 1-, 2-, 3-, and 5-year survival rate, and overall survival (OS) were analyzed and compared.


RESULTS
Eighteen studies included a total of 2,120 patients with HCC 1,071 and 1,049 patients for treatment with combination therapy and monotherapy, respectively. The combination therapy group had a significantly better survival in terms of 1-, 2-, 3-, and 5-year survival rate (RR 1.10, 95 % CI 1.03–1.18, P = 0.005; RR 1.20, 95 % CI 1.10–1.30, P < 0.0001; RR 1.43, 95 % CI 1.18–1.73, P < 0.0001; RR 1.40, 95 % CI 1.22–1.61, P < 0.0001, respectively), OS (HR 0.66, 95 % CI 0.51–0.85, P = 0.001), and response rate (RR 1.54, 95 % CI 1.09–2.18, P = 0.013) than that monotherapy group in patients with HCC.


CONCLUSIONS
The meta-analysis indicates that the combination of TACE with local ablative therapy was superior to monotherapy in the treatment for patients with HCC.
Lili
L
Gu
Huiling
H
Liu
Linlin
L
Fan
Yuanjun
Y
Lv
Zhuang
Z
Cui
Yan
Y
Luo
Yuanyuan
Y
Liu
Guang
G
Li
Changping
C
Li
Jun
J
Ma
D006801:Humans; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome