Meta-analysis of transarterial chemoembolization combined with cryoablation vs transarterial chemoembolization alone for≥5 cm hepatocellular carcinoma  

作　　者：Jie-Fei Cheng Qiu-Lian Sun Ling Tang Xin-Jian Xu Xiang-Zhong Huang 

机构地区：[1]Department of Radiology,The Fifth People’s Hospital of Taizhou,Taizhou 225300,Jiangsu Province,China [2]Department of Radiology,The Fifth People’s Hospital of Suzhou,Suzhou 215100,Jiangsu Province,China [3]Department of Radiology,The Fourth People’s Hospital of Taizhou,Taizhou 225300,Jiangsu Province,China [4]Department of Interventional Radiology,Jiangyin People Hospital,Jiangyin 214400,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第6期2793-2803,共11页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)ranks sixth globally in cancer incidence and third in mortality rates.Unfortunately,over 70% of HCC patients forego the opportunity for curative surgery or liver transplantation due to inadequate physical examinations,poor physical condition,and limited organ availability upon diagnosis.Clinical guidelines endorse transarterial chemoembolization(TACE)as the frontline treatment for intermediate to advanced-stage HCC.Cryoablation(CRA)is an emerging local ablative therapy increasingly used in HCC management.Recent studies suggest that combining CRA with TACE offers complementary and synergistic effects,potentially improving long-term survival rates.However,the superiority of combined TACE+CRA therapy over TACE alone for HCC lesions equal to or exceeding 5 cm requires further investigation.AIM To compare the efficacy and safety of TACE combined with CRA vs TACE alone in the treatment of HCC with a diameter of≥5 cm.METHODS PubMed,EMBASE,Cochrane Library,CNKI,Wanfang,and VIP databases were searched to retrieve all relevant studies on TACE and CRA up to July 2022.Meta-analysis was performed using RevMan 5.3 software.RESULTS After screening according to the inclusion and exclusion criteria,6 articles were included,including 2 randomized controlled trials and 4 nonrandomized controlled trials,with a total of 575 patients included in the meta-analysis.The results showed that the objective response rate[odds ratio(OR)=2.56,95%confidence interval(CI):1.66-3.96,P<0.0001],disease control rate(OR=3.03,95%CI:1.88-4.89,P<0.00001),1-year survival rate(OR=3.79,95%CI:2.50-5.76,P<0.00001),2-year survival rate(OR=2.34,95%CI:1.43-3.85,P=0.0008),and 3-year survival rate(OR=3.34,95%CI:1.61-6.94,P=0.001)were all superior to those of the control group;the postoperative decrease in alpha-fetoprotein value(OR=295.53,95%CI:250.22-340.85,P<0.0001),the postoperative increase in CD4 value(OR=10.59,95%CI:8.78-12.40,P<0.00001),and the postoperative decrease in CD8 value(OR=6.47,95%CI:4.44-8.50,P<0.00001)we

关 键 词：Hepatic cancer CRYOABLATION CHEMOEMBOLIZATION Transarterial chemoembolization Meta analysis 

分 类 号：R735.7[医药卫生—肿瘤]