scholarly journals Comparison of Radiofrequency Ablation with or without Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Xinxin Wang ◽  
Yang Che ◽  
Shiyong Chen ◽  
Biao Wu ◽  
Yu He ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Randomized Controlled Trials ◽  
Tumor Progression ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Arterial Chemoembolization

Abstract Background To evaluate the curative effect and safety of compare radiofrequency ablation (RFA) with or without transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC)with the help of a meta-analysis of randomized controlled trials (RCTs) . Materials and Methods RCTs comparing TACE combined with RFA and RFA alone were searched electronically using PubMed, The Cochrane Library, and EMBASE. Fixed and random-effects were used to measure pooled estimates. Research indicators included overall survival (OS), recurrence-free survival (RFA), tumor progression and complications. Results Overall, 6 RCTs were included in this meta-analysis, with a total of 527 patients (TACE-RFA: 271; RFA: 256). 3- and5-year OS rate was higher in the TACE-RFA group than in the RFA group (OR = 1.74; 95% CI: 1.17–2.59; p = 0.006; OR = 2.19; 95% CI: 1.49–3.22; p < 0.0001). The 3- and 5-year RFS rate in the TACE-RFA group was higher than that in the RFA group (OR = 1.92, 95% CI: 1.30 ~ 2.82, p = 0.0009; OR = 1.81, 95% CI: 1.21 ~ 2.70, p = 0.004, respectively). The rate of tumor progression was lower in the TACE-RFA group than in the RFA group (OR = 0.57; 95% CI: 0.38 ~ 0.85; p = 0.005). No significant differences in terms of 1-year OS rate and complications rate were observed between groups.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

scholarly journals Individual or combined transcatheter arterial chemoembolization and radiofrequency ablation for hepatocellular carcinoma: a time-to-event meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chuang Jiang ◽  
Gong Cheng ◽  
Mingheng Liao ◽  
Jiwei Huang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Similar Rate ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Arterial Chemoembolization

Abstract Background There is still some debate as to whether transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is better than TACE or RFA alone. This meta-analysis aimed to compare the efficacy and safety of TACE plus RFA for hepatocellular carcinoma (HCC) with RFA or TACE alone. Methods We searched PubMed, MEDLINE, Embase, Cochrane Library, and CNKI (China National Knowledge Infrastructure) for all relevant randomized controlled trials and retrospective studies reporting overall survival (OS), recurrence-free survival (RFS), and complications of TACE plus RFA for HCC, compared with RFA or TACE alone. Results Twenty-one studies involving 3413 patients were included. TACE combined with RFA was associated with better OS (hazard ratio [HR]=0.62, 95% confidence intervals [CI] = 0.55–0.71, P < 0.001) and RFS (HR = 0.52, 95% CI = 0.39–0.69, P < 0.001) than TACE alone; compared with RFA alone, TACE plus RFA resulted in longer OS (HR = 0.63, 95% CI = 0.53–0.75, P < 0.001) and RFS (HR = 0.60, 95% CI = 0.51–0.71, P < 0.001). Subgroup analyses by tumor size also showed that combined treatment resulted in better OS and RFS compared with RFA alone in patients with HCC larger than 3 cm. Combined treatment resulted in similar rate of major complications compared with TACE or RFA alone (OR = 1.78, 95% CI = 0.99–3.20, P = 0.05; OR = 1.00, 95% CI = 0.42–2.38, P = 1.00, respectively). Conclusions TACE combined with RFA was more effective for HCC than TACE alone. For patients with a tumor larger than 3 cm, the combined treatment also achieved a better effect than RFA alone.

scholarly journals Effect of Aidi Injection plus TACE on Hepatocellular Carcinoma: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Yaoyao Dai ◽  
Sicheng Gao ◽  
Xing Liu ◽  
Qin Gao ◽  
Lan Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Randomized Controlled Trials ◽  
Clinical Effect ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Aidi Injection

We aim to conduct a meta-analysis of studies on the effect of Aidi injection combined with TACE in the treatment of hepatocellular carcinoma (HCC). China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), Allied and Complementary Medicine Database (AMED), EMBASE, Web of Science, PubMed, and Cochrane Library databases to October 1, 2017, were searched to collect the studies. The data analysis was performed using RevMan 5.3 software. Totally 20 clinical trials with 774 (the experimental group: 447 cases; the control group: 327 cases) HCC patients were finally included in this meta-analysis. Meta-analysis results showed that Aidi injection combined with TACE can, to some extent, enhance the clinical effect and improve the overall survival. Meanwhile, it can increase HCC patients’ quality of life. Additionally, Aidi injection plus TACE can reduce adverse events including leukopenia, gastrointestinal reaction, and liver damage in HCC patients (all P < 0.05). Therefore, Aidi injection plus TACE may significantly enhance the clinical effect, suggesting that the combination of TCM and western medicine is promising. The exact outcome needs rigorously designed performances, multicenter, and large randomized controlled trials.

Comparison of Radiofrequency Ablation and Cryoablation for Paroxysmal Atrial Fibrillation：A Meta-Analysis of Randomized Controlled Trials. (Preprint)

2021 ◽  
Author(s):  
Xiaoxv Yang ◽  
Hui-Yuan Zhou ◽  
Ya-Le Lu
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Randomized Controlled Trials ◽  
Paroxysmal Atrial Fibrillation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
One Year ◽  
Better Than

BACKGROUND Some studies have compared the effects of radiofrequency current energy and cryoballoon in patients with paroxysmal atrial fibrillation. The results on the rate of atrial fibrillation and the incidence of complications one year after ablation were inconsistent with these studies. OBJECTIVE The purpose of this study was to evaluate whether the efficacy and safety of cryoballoon (CB) are better than that of radiofrequency ablation(RF) for pulmonary vein isolation in the treatment of paroxysmal atrial fibrillation(PAF). METHODS The Pubmed and Cochrane Library databases were searched for randomized controlled trials(RCTs) since inception through August 2020. The efficacy outcome was success rate one year after ablation. Rate of complications safety outcome. Included studies were RCTs in adults with PAF in which CB therapy was compared to RF therapy. Two investigators extracted data from the selected studies and assessed the risk of bias. RESULTS A total of 6 RCTs with 1681 individuals were included in the analysis. Pooled analyses indicated that CB ablation had a lower rate of the free-from atrial fibrillation(AF) one year after catheter ablation than RF therapy,but not statistically significant (OR: 0.88; 95% CI: 0.57 to 1.36;p=0.57). There was a higher rate of complications in the CB group,but not significant (OR: 1.27;95% CI: 0.73 to 2.22;p=0.39). CONCLUSIONS This meta-analysis shows that CB is not better than RF for patients with paroxysmal atrial fibrillation, and the incidence of complications is not lower than RF.

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