Korean Journal of Radiology

  • 제19권4호
  • /
  • Pages.613-622
  • /
  • 2018
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Radiofrequency Ablation Combined with Transcatheter Arterial Chemoembolization Therapy Versus Surgical Resection for Hepatocellular Carcinoma within the Milan Criteria: A Meta-Analysis

  • Wang, Wei-dong (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Zhang, Li-hua (Guangdong Women an Children Hospital, Guangzhou Medical University) ;
  • Ni, Jia-Yan (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Jiang, Xiong-ying (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Chen, Dong (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Chen, Yao-ting (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Sun, Hong-liang (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Luo, Jiang-hong (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University) ;
  • Xu, Lin-feng (Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
  • 투고 : 2017.07.06
  • 심사 : 2018.01.15
  • 발행 : 2018.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To meta-analytically compare combined transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) and surgical resection (SR) for the treatment of hepatocellular carcinoma (HCC) within the Milan criteria. Materials and Methods: PubMed, Medline, Embase, and Cochrane Library were searched for studies comparing these two therapies that were published between January 2006 and August 2017. Overall survival rate (OS), recurrence-free survival rate (RFS), major complications and the average length of hospital stay were compared between these two therapies. Meta-analytic pooled odds ratio (OR) was calculated using TACE plus RFA as the base category. Results: Seven case-control studies and one randomized trial were identified. Meta-analytic results revealed that, compared with SR, TACE plus RFA had significantly higher 1-year OS (OR for survival = 0.50, p = 0.009) and lower major complications (OR = 1.88, p = 0.02) after therapy. Three studies reported on the length of hospital stay. The average $length{\pm}standard$ deviation reported in individual studies for SR and TACE plus RFA groups was $19.8{\pm}8.4days$ and $7.4{\pm}2.2days$, respectively; $18.7{\pm}4.9days$ and $11.5{\pm}6.9days$, respectively; and $16.6{\pm}6.7days$ and $8.5{\pm}4.1days$, respectively (p < 0.0001 for all studies). Three or 5-year OS and 1-, 3-, or 5-year RFS did not significantly differ between the two therapies. Conclusion: Combined TACE plus RFA may be an alternative to SR for the treatment of patients with HCC within Milan the criteria. Non-randomized design in most of the original studies was a limitation.

키워드

참고문헌

  1. Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet 2012;379:1245-1255 https://doi.org/10.1016/S0140-6736(11)61347-0
  2. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-2917 https://doi.org/10.1002/ijc.25516
  3. Han KH, Kudo M, Ye SL, Choi JY, Poon RT, Seong J, et al. Asian consensus workshop report: expert consensus guideline for the management of intermediate and advanced hepatocellular carcinoma in Asia. Oncology 2011;81 Suppl 1:158-164
  4. Hsu CY, Hsia CY, Huang YH, Su CW, Lin HC, Lee PC, et al. Selecting an optimal staging system for hepatocellular carcinoma: comparison of 5 currently used prognostic models. Cancer 2010;116:3006-3014 https://doi.org/10.1002/cncr.25044
  5. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-1022 https://doi.org/10.1002/hep.24199
  6. European Association For The Study Of The Liver; European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012;56:908-943 https://doi.org/10.1016/j.jhep.2011.12.001
  7. Lam VW, Ng KK, Chok KS, Cheung TT, Yuen J, Tung H, et al. Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma. J Am Coll Surg 2008;207:20-29 https://doi.org/10.1016/j.jamcollsurg.2008.01.020
  8. Minami Y, Kudo M. Radiofrequency ablation of hepatocellular carcinoma: a literature review. Int J Hepatol 2011;2011:104685
  9. Pompili M, Saviano A, de Matthaeis N, Cucchetti A, Ardito F, Federico B, et al. Long-term effectiveness of resection and radiofrequency ablation for single hepatocellular carcinoma $\leq$3 cm. Results of a multicenter Italian survey. J Hepatol 2013;59:89-97 https://doi.org/10.1016/j.jhep.2013.03.009
  10. Fang Y, Chen W, Liang X, Li D, Lou H, Chen R, et al. Comparison of long-term effectiveness and complications of radiofrequency ablation with hepatectomy for small hepatocellular carcinoma. J Gastroenterol Hepatol 2014;29:193-200 https://doi.org/10.1111/jgh.12441
  11. Peng ZW, Zhang YJ, Chen MS, Xu L, Liang HH, Lin XJ, et al. Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol 2013;31:426-432
  12. Morimoto M, Numata K, Kondo M, Moriya S, Morita S, Maeda S, et al. Radiofrequency ablation combined with transarterial chemoembolization for subcapsular hepatocellular carcinoma: a prospective cohort study. Eur J Radiol 2013;82:497-503 https://doi.org/10.1016/j.ejrad.2012.09.014
  13. Ni JY, Liu SS, Xu LF, Sun HL, Chen YT. Transarterial chemoembolization combined with percutaneous radiofrequency ablation versus TACE and PRFA monotherapy in the treatment for hepatocellular carcinoma: a meta-analysis. J Cancer Res Clin Oncol 2013;139:653-659 https://doi.org/10.1007/s00432-012-1369-x
  14. Wang X, Hu Y, Ren M, Lu X, Lu G, He S. Efficacy and safety of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinomas compared with radiofrequency ablation alone: a time-to-event metaanalysis. Korean J Radiol 2016;17:93-102 https://doi.org/10.3348/kjr.2016.17.1.93
  15. Li S, Zhang L, Huang ZM, Wu PH. Transcatheter arterial chemoembolization combined with CT-guided percutaneous thermal ablation versus hepatectomy in the treatment of hepatocellular carcinoma. Chin J Cancer 2015;34:254-263
  16. Liu H, Wang ZG, Fu SY, Li AJ, Pan ZY, Zhou WP, et al. Randomized clinical trial of chemoembolization plus radiofrequency ablation versus partial hepatectomy for hepatocellular carcinoma within the Milan criteria. Br J Surg 2016;103:348-356 https://doi.org/10.1002/bjs.10061
  17. Takuma Y, Takabatake H, Morimoto Y, Toshikuni N, Kayahara T, Makino Y, et al. Comparison of combined transcatheter arterial chemoembolization and radiofrequency ablation with surgical resection by using propensity score matching in patients with hepatocellular carcinoma within Milan criteria. Radiology 2013;269:927-937 https://doi.org/10.1148/radiol.13130387
  18. Yamakado K, Nakatsuka A, Takaki H, Yokoi H, Usui M, Sakurai H, et al. Early-stage hepatocellular carcinoma: radiofrequency ablation combined with chemoembolization versus hepatectomy. Radiology 2008;247:260-266 https://doi.org/10.1148/radiol.2471070818
  19. Kim JW, Shin SS, Kim JK, Choi SK, Heo SH, Lim HS, et al. Radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of single hepatocellular carcinoma of 2 to 5 cm in diameter: comparison with surgical resection. Korean J Radiol 2013;14:626-635 https://doi.org/10.3348/kjr.2013.14.4.626
  20. Kagawa T, Koizumi J, Kojima S, Nagata N, Numata M, Watanabe N, et al.; Tokai RFA Study Group. Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection. Cancer 2010;116:3638-3644 https://doi.org/10.1002/cncr.25142
  21. Lee HJ, Kim JW, Hur YH, Shin SS, Heo SH, Cho SB, et al. Combined therapy of transcatheter arterial chemoembolization and radiofrequency ablation versus surgical resection for single 2-3 cm hepatocellular carcinoma: a propensity-score matching analysis. J Vasc Interv Radiol 2017;28:1240-1247.e3 https://doi.org/10.1016/j.jvir.2017.05.015
  22. Bholee AK, Peng K, Zhou Z, Chen J, Xu L, Zhang Y, et al. Radiofrequency ablation combined with transarterial chemoembolization versus hepatectomy for patients with hepatocellular carcinoma within Milan criteria: a retrospective case-control study. Clin Transl Oncol 2017;19:844-852 https://doi.org/10.1007/s12094-016-1611-0
  23. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010;25:603-605 https://doi.org/10.1007/s10654-010-9491-z
  24. Oremus M, Oremus C, Hall GB, McKinnon MC; ECT & Cognition Systematic Review Team. Inter-rater and test-retest reliability of quality assessments by novice student raters using the Jadad and Newcastle-Ottawa Scales. BMJ Open 2012;2. pii:e001368
  25. Feng K, Yan J, Li X, Xia F, Ma K, Wang S, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol 2012;57:794-802 https://doi.org/10.1016/j.jhep.2012.05.007
  26. Wang JH, Wang CC, Hung CH, Chen CL, Lu SN. Survival comparison between surgical resection and radiofrequency ablation for patients in BCLC very early/early stage hepatocellular carcinoma. J Hepatol 2012;56:412-418 https://doi.org/10.1016/j.jhep.2011.05.020
  27. Feng Q, Chi Y, Liu Y, Zhang L, Liu Q. Efficacy and safety of percutaneous radiofrequency ablation versus surgical resection for small hepatocellular carcinoma: a meta-analysis of 23 studies. J Cancer Res Clin Oncol 2015;141:1-9 https://doi.org/10.1007/s00432-014-1708-1
  28. Kim JM, Kang TW, Kwon CH, Joh JW, Ko JS, Park JB, et al. Single hepatocellular carcinoma $\leq$ 3 cm in left lateral segment: liver resection or radiofrequency ablation? World J Gastroenterol 2014;20:4059-4065 https://doi.org/10.3748/wjg.v20.i14.4059
  29. Ke S, Ding XM, Kong J, Gao J, Wang SH, Cheng Y, et al. Low temperature of radiofrequency ablation at the target sites can facilitate rapid progression of residual hepatic VX2 carcinoma. J Transl Med 2010;8:73 https://doi.org/10.1186/1479-5876-8-73
  30. Roayaie S, Obeidat K, Sposito C, Mariani L, Bhoori S, Pellegrinelli A, et al. Resection of hepatocellular cancer $\leq$2 cm: results from two Western centers. Hepatology 2013;57:1426-1435 https://doi.org/10.1002/hep.25832
  31. Shibata T, Isoda H, Hirokawa Y, Arizono S, Shimada K, Togashi K. Small hepatocellular carcinoma: is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment? Radiology 2009;252:905-913 https://doi.org/10.1148/radiol.2523081676
  32. Kim JH, Won HJ, Shin YM, Kim SH, Yoon HK, Sung KB, et al. Medium-sized (3.1-5.0 cm) hepatocellular carcinoma: transarterial chemoembolization plus radiofrequency ablation versus radiofrequency ablation alone. Ann Surg Oncol 2011;18:1624-1629 https://doi.org/10.1245/s10434-011-1673-8
  33. Morimoto M, Numata K, Kondou M, Nozaki A, Morita S, Tanaka K. Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization. Cancer 2010;116:5452-5460 https://doi.org/10.1002/cncr.25314
  34. Veltri A, Moretto P, Doriguzzi A, Pagano E, Carrara G, Gandini G. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol 2006;16:661-669 https://doi.org/10.1007/s00330-005-0029-9
  35. Yang W, Chen MH, Wang MQ, Cui M, Gao W, Wu W, et al. Combination therapy of radiofrequency ablation and transarterial chemoembolization in recurrent hepatocellular carcinoma after hepatectomy compared with single treatment. Hepatol Res 2009;39:231-240 https://doi.org/10.1111/j.1872-034X.2008.00451.x
  36. Siriapisith T, Siwasattayanon P, Tongdee T. Radiofrequency ablation alone versus radiofrequency ablation combined with chemoembolization in unresectable hepatocellular carcinoma. J Med Assoc Thai 2012;95:430-436
  37. Li JX, Wu H, Huang JW, Zeng Y. The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma. J Formos Med Assoc 2012;111:510-515 https://doi.org/10.1016/j.jfma.2011.05.016
  38. Guo W, He X, Li Z, Li Y. Combination of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) vs. surgical resection (SR) on survival outcome of early hepatocellular carcinoma: a meta-analysis. Hepatogastroenterology 2015;62:710-714

피인용 문헌

  1. A Glimpse on Trends and Characteristics of Recent Articles Published in the Korean Journal of Radiology vol.20, pp.12, 2019, https://doi.org/10.3348/kjr.2019.0928
  2. Curative Loco-regional Therapies for Early Hepatocellular Carcinoma: Is Combination Effective? vol.73, pp.3, 2019, https://doi.org/10.4166/kjg.2019.73.3.121
  3. Efficacy and safety of transarterial chemoembolisation with cone-beam CT in patients with hepatocellular carcinoma within the Milan criteria: a retrospective cohort study vol.74, pp.5, 2018, https://doi.org/10.1016/j.crad.2019.01.024
  4. Combination of the gamma-glutamyltransferase-to-prealbumin ratio and other indicators may be a novel marker for predicting the prognosis of patients with hepatocellular carcinoma undergoing locoregion vol.14, pp.1, 2018, https://doi.org/10.1186/s13027-019-0266-1
  5. Genomic DNA methylation profiling indicates immune response following thermal ablation treatment for HBV-associated hepatocellular carcinoma vol.20, pp.1, 2018, https://doi.org/10.3892/ol.2020.11636
  6. Trans-arterial chemoembolization + radiofrequency ablation versus surgical resection in hepatocellular carcinoma – A meta-analysis vol.46, pp.5, 2018, https://doi.org/10.1016/j.ejso.2020.01.004
  7. Hyperthermia ablation combined with transarterial chemoembolization versus monotherapy for hepatocellular carcinoma: A systematic review and meta‐analysis vol.10, pp.23, 2021, https://doi.org/10.1002/cam4.4350