Treatment outcomes of transcatheter arterial chemoembolization combined with local ablative therapy versus monotherapy in hepatocellular carcinoma: a meta-analysis

Purpose 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.