Sorafenib combined with radiofrequency ablation as treatment for patients with hepatocellular carcinoma: a systematic review and meta-analysis

Purpose: To evaluate the safety and efficacy of a combination of sorafenib and radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). Methods: A systematic literature search was conducted using PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WanFang Database, for all years up to January 2017. Pooled analyses of overall survival (OS), tumor-free survival, recurrence rates and adverse events were performed. Results: IA total of 7 case control studies consisting of 1765 HCC patients were selected and included in this meta-analysis. Patients treated with sorafenib-RFA and sorafenib alone, RFA alone and surgery had no significant differences in 1-year OS (p=0.310), 2-year OS (p=0.262), 3-year OS (p=0.179), 4-year OS (p=0.238) and 5-year OS (p=0.933); 1-year recurrence rate (p=0.653), 2-year recurrence rate (p=0.416), 3-year recurrence rate (p=0.304), and 5-year recurrence rate (p=0.807); 1-year tumor-free survival rate (p=0.943), 3-year tumor-free survival rate (p=0.825), 5-year tumor-free survival rate (p=0.893) and overall adverse events (p=0.097). Conclusion: RFA-sorafenib combination may not be a better approach for patients with HCC. More well-designed randomized clinical trials (RCTs) should be performed before we finally arrive at a rational comprehension about the therapeutic value of the discussed options.