Meta-analysis of radiofrequency ablation in combination with transarterial chemoembolization for hepatocellular carcinoma

Table 1 Baseline characteristics of the trials included in the meta-analysis (mean ± SD)

Ref.	Country	Design	Treatment	No. of patients	Age (yr)	Sex (male/female)	Tumor size (cm)	Child-Pugh class (A/B/C)
Peng et al[14]	China	RCT	TACE + RFA	69	57.5 ± 10.0	60/9	≤ 5.01	60/9/0
			RFA	70	55.1 ± 9.5	55/15	-	59/11/0
Cheng et al[15]	China	RCT	TACE + RFA	96	≤ 751	NA	3 < TS ≤ 7.51	NA
			RFA	100	-	-	-	NA
Yang et al[16]	China	RCT	TACE + RFA	24	59.1 ± 11.4	18/6	6.6 ± 0.6	NA
			RFA	12	61.0 ± 10.4	8/4	5.2 ± 0.4	NA
Shibata et al[18]	Japan	RCT	TACE + RFA	46	67.2 ± 8.9	31/15	1.7 ± 0.6	32/14/0
			RFA	43	69.8 ± 8.0	33/10	1.6 ± 0.5	33/10/0
Morimoto et al[20]	Japan	RCT	TACE + RFA	19	70 (57-78)	15/4	3.6 ± 0.7	12/7/0
			RFA	18	73 (48-84)	12/6	3.7 ± 0.6	16/2/0
Kang et al[22]	China	RCT	TACE + RFA	19	52.2	14/5	6.7 ± 1.1	12/7/0
			RFA	18	50.7	14/4	6.2 ± 1.2	12/6/0
Shen et al[23]	China	RCT	TACE + RFA	18	52.7 (20-72)	5/13	5.6 (2.2-15.8)	4/14/0
			RFA	16	56.1 (36-75)	3/13	5.0 (2.3-12.3)	6/10/0
Zhang et al[24]	China	RCT	TACE + RFA	15	57.8 (39-72)	12/3	4.6 (2.3-7.1)	NA
			RFA	15	61.8 (38-78)	13/2	4.1 (2.4-6.0)	NA

¹Total data of relative study. RCT: Randomized controlled trial; NA: Not applicable; TS: Tumor size; RFA: Radiofrequency ablation; TACE: Transcatheter arterial chemoembolization.

Table 2 Prognosis of patients reported in the trials included in the meta-analysis

Ref.	Treatment	No. of patients	Recurrence- free survival rate			Overall survival rate
			1 yr	3 yr	5 yr	1 yr	2 yr	3 yr	5 yr
Peng et al[14]	TACE+RFA	69	80.00%	45.00%	40.00%	94.00%	NA	69.00%	46.00%
	RFA	70	64.00%	18.00%	18.00%	82.00%		47.00%	36.00%
Cheng et al[15]	TACE+RFA	96	NA	NA	58.00%	83.00%	NA	55.00%	31.00%
	RFA	100			42.00%	67.00%		32.00%	8.00%
Yang et al[16]	TACE+RFA	24	29.00%	NA	NA	68.00%	NA	NA	NA
	RFA	12	34.70%			57.00%
Shibata et al[18]	TACE+RFA	46	71.30%	48.80%	NA	100.00%	100.00%	84.80%	NA
	RFA	43	74.30%	29.70%		100.00%	88.80%	84.50%
Morimoto et al[20]	TACE+RFA	19	67.00%	NA		100.00%	93.00%	93.00%	NA
	RFA	18	56.00%	28.00%		89.00%	89.00%	80.00%
Kang et al[22]	TACE+RFA	19	NA	NA	NA	84.20%	42.10%	36.80%	NA
	RFA	18				66.10%	22.20%	16.70%
Shen et al[23]	TACE+RFA	18	63.90%	50.00%	NA	87.50%	NA	73.30%	NA
	RFA	16	30.00%	18.70%		52.20%		20.40%
Zhang et al[24]	TACE+RFA	15	NA	NA	NA	100.00%	NA	NA	NA
	RFA	15				80.00%

NA: Not applicable; RFA: Radiofrequency ablation; TACE: Transcatheter arterial chemoembolization.

Table 3 Efficacy and major complications of radiofrequency ablation-transcatheter arterial chemoembolization vs radiofrequency ablation for treatment of hepatocellular carcinoma

Variables	No. of studies furnishing data	Results		OR (95%CI)	P value	I2
		RFA-TACE	RFA
Efficacy overall survival rate
1 yr	8	89.20%	76.00%	2.96 (1.84- 7.47)	< 0.001	0.00%
2 yr	3	85.70%	73.40%	3.72 (1.24-11.16)	0.02	0.00%
3 yr	6	66.70%	45.70%	2.65 (1.81- 3.86)	< 0.001	13.10%
5 yr	2	37.50%	19.40%	2.78 (0.85-9.12)	0.09	79.30%
Recurrence-free survival rate
1 yr	5	67.60%	60.30%	1.59 (0.99-2.55)	0.05	3.50%
3 yr	3	46.60%	22.40%	3.00 (1.75-5.13)	< 0.001	0.00%
5 yr	2	50.90%	32.30%	2.26 (1.43-3.57)	0.0004	0.00%
Survival rate (TS ≤ 3 cm)
1 yr	2	98.90%	91.00%	8.42 (1.01- 70.56)	0.05	NA
3 yr	2	78.10%	71.90%	1.35 (0.67-2.74)	0.4	0.00%
Survival rate (3 cm < TS ≤ 5 cm)
1 yr	4	95.30%	84.60%	3.46 (1.29-9.28)	0.01	0.00%
3 yr	3	78.20%	53.90%	3.58 (1.79-7.15)	0.0003	28.60%
5 yr	2	49.30%	15.40%	5.34 (2.42-11.75)	< 0.001	0.00%
Survival rate (TS < 5 cm)
1 yr	4	75.90%	52.50%	2.91 (1.60-5.29)	0.0004	0.00%
3 yr	3	43.10%	10.30%	6.96 (3.01-16.07)	0.00001	0.00%
Tumor progression rate	6	31.60%	42.80%	0.60 (0.42-0.88)	0.008	34.80%
Major complications	3	3.70%	3.10%	1.20 (0.31-4.62)	0.79	0.00%

NA: Not applicable; TS: Tumor size; RFA: Radiofrequency ablation; TACE: Transcatheter arterial chemoembolization.