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Page 4 of 9 Yang et al. Hepatoma Res 2019;5:13 I http://dx.doi.org/10.20517/2394-5079.2019.04

(n = 1487)

(n = 1304)

(n = 1304)

(n = 62)
(n = 73)
(n = 28)
(n = 14)
(n = 14)
(n = 11) (n = 3)
(n = 3)

(n = 11)

Figure 1. Flow diagram of the detailed selection process of this meta-analysis. A total of 11 RCTs [11-21] [Table 1] were included in the study.
There were 691 eligible patients, of whom 357 received TACE with RFA, and 334 received TACE alone. The baseline characteristics
of the trials included in the meta-analysis are shown in Table 1. The quality of the included studies was assessed using the Cochrane
Collaboration Tool

Eighteen-month survival rate
Six studies [15,16,18-21] (involving 309 participants) compared eighteen-month survival of the TACE with RFA
group vs. the TACE alone group. The results showed that eighteen-month survival rate was higher in the
TACE with RFA group than in the TACE alone group [RR = 1.792, 95%CI: 1.423-2.256, P < 0.001, I = 0%]
2
[Figure 5].

Two-year survival rate
Three studies [14,17,20] (involving 285 participants) compared the 2-year survival rate of the TACE with RFA
group vs. the TACE alone group. The results showed that 2-year survival rate was higher in the TACE with
RFA group than in the TACE alone group [RR = 1.675, 95%CI: 1.233-2.275, P = 0.001, I = 0%] [Figure 6].
2
Incidence of fever
Three studies [11,12,20] (involving 194 participants) compared the incidence of fever of the TACE with RFA
group vs. the TACE alone group, and showed that there was no significant difference between the two groups
2
[RR = 1.177, 95%CI: 0.904-1.532, P = 0.227, I = 0%] [Figure 7].

Publication bias assessment
Based on statistical analysis, the meta-analysis of TACE with RFA vs. TACE alone obtained better symmetry
[22]
of the funnel plot and can be assessed without significant publication bias in the study literature [Figure 8].

DISCUSSION
Compared to treatment with TACE alone, this study showed that TACE combined with RFA showed
significantly better outcomes on tumor response rate [RR = 1.452, 95%CI: 1.308-1.610, P < 0.001], six-month