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Page 6 of 9 Yang et al. Hepatoma Res 2019;5:13 I http://dx.doi.org/10.20517/2394-5079.2019.04

Figure 5. Eighteen-month survival rate of TACE with RFA vs. TACE alone

Figure 6. Two-year survival rate of TACE with RFA vs. TACE alone

Figure 7. Incidence of fever in the TACE with RFA group vs. TACE alone group

funnel plots indicates that there is no significant bias in this meta-analysis. The overall quality of the studies
included in this meta-analysis was evaluated to be of high quality, which gives confidence to our results.

HCC is a serious global health problem and the third most common cause of cancer death. Most patients
with HCC are diagnosed with intermediate or advanced stage, with baseline liver dysfunction, intrahepatic
metastasis or excessive load, and are not suitable for surgical resection. The established local treatment
options include TACE, RFA, ethanol injection, and microwave coagulation; however, it is still unclear which
method is the most efficacious [23-25] . In the 2018 NCCN Clinical Practice Guidelines for Malignancies, TACE
is recommended as a first-line palliative treatment for unresectable HCC. However, the tumor response
rate and survival rate of patients treated with TACE alone are not ideal. Therefore, the treatment of TACE
combined with other local treatment options such as RFA for comprehensive treatment is gradually being
adopted.