Abstract
Purpose
The application of high-intensity focused ultrasound (HIFU) in hepatocellular carcinoma (HCC) was promising. However, whether the effect of HIFU is comparable with that of transarterial chemoembolization (TACE) has not been determined.
Materials and methods
PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, CqVip, CNKI, and CBM databases were searched for randomized controlled trials (RCTs), cohort studies, and case-control studies. The methodological quality of each study was evaluated. When there is no statistical heterogeneity, the fixed effect model would be used to merge data. Otherwise, the random effect model would be utilized. Sensitivity analyses were conducted by excluding one study each time. Subgroup analyses were conducted based on age, sex, tumor number, relative number of the patients with Child-Pugh C grade in each group, the percentage of patients with Child-Pugh C grade in the whole study, and tumor load. Publication bias was evaluated by Egger’s test and Begg’s test.
Results
Six cohort studies including 188 patients from HIFU group and 224 patients from TACE group were obtained for further analysis. The meta-analysis suggested HIFU and TACE showed no differences in postoperative 1-year overall survival (OS) rate, tumor response (including complete response, partial response, stable disease, and progressive disease), and postoperative complications. Moreover, compared with TACE, HIFU showed higher postoperative 6-month and 2-year OS rates. Subgroup analyses, meta regression analysis and sensitivity analyses indicated the findings above were reliable. Additionally, no potential publication bias was detected.
Conclusion
For HCC, when compared with TACE, HIFU might show comparable safety but better effect. Considering the limitations of current studies, more well-designed studies are needed to validate our conclusion.
Acknowledgments
We are extremely thankful to authors of all the included papers for their providing suitable data for analysis.
Author contributions
Conception and design: Wang YB, Zeng HS, Salameen H, and Ding X; Administrative support: None; Provision of study materials or patients: None; Collection and assembly of data: Wang YB, Miao CM, and Chen L; Data analysis and interpretation: All authors; Manuscript writing: All authors; Final approval of manuscript: All authors.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Yun-Bing Wang
Yun-Bing Wang, PhD, is a clinical doctor at The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Hou-Shuai Zeng
Hou-Shuai Zeng is a MD student at The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Haitham Salameen
Haitham Salameen, MD, is a PhD student at The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Chun-Mu Miao
Chun-Mu Miao, PhD, is a clinical doctor at The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Long Chen
Long Chen, MD, is a clinical doctor at Pidu District People’s Hospital, Chengdu, Sichuan, China.
Xiong Ding
Xiong Ding, PhD, is a professor and clinical doctor at The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.