标题：RETRACTED: Chemoembolization combined with radiofrequency ablation for patients with hepatocellular carcinoma larger than 3 cm - A randomized controlled trial (Retracted article. See vol. 301, pg. 1931, 2009)
作者：Cheng, Bao-Quan; Jia, Chong-Qi; Liu, Chun-Tao; Fan, Wei; Wang, Qing-Liang; Zhang, Zong-Li; Yi, Cui-Hua
作者机构：[Cheng, Bao-Quan; Liu, Chun-Tao; Fan, Wei] Shandong Univ, Qilu Hosp, Dept Gastroenterol, Sch Med, Jinan 250012, Peoples R China.; [Wang, Qing-Liang] 更多
通讯作者地址：[Cheng, BQ]Shandong Univ, Qilu Hosp, Dept Gastroenterol, Sch Med, Jinan 250012, Peoples R China.
来源：JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
摘要：Context Transarterial chemoembolization ( TACE) combined with radiofrequency ablation ( RFA) therapy has been used for patients with large hepatocellular carcinoma tumors, but the survival benefits of combined treatment are not known.; Objective To compare rates of survival of patients with large hepatocellular carcinoma tumors who received treatment with TACE combined with RFA therapy ( TACE- RFA), TACE alone, and RFA alone.; Design, Setting, and Patients Randomized controlled trial conducted from January 2001 to May 2004 among 291 consecutive patients with hepatocellular carcinoma larger than 3 cm at a single center in China.; Intervention Patients were randomly assigned to treatment with combined TACE- RFA ( n= 96), TACE alone ( n= 95), or RFA alone ( n= 100).; Main Outcome Measures The primary end point was survival and the secondary end point was objective response rate.; Results During a median 28.5 months of follow- up, median survival times were 24 months in the TACE group ( 3.4 courses), 22 months in the RFA group ( 3.6 courses), and 37 months in the TACE- RFA group ( 4.4 courses). Patients treated with TACE-RFA had better overall survival than those treated with TACE alone ( hazard ratio [ HR], 1.87; 95% confidence interval [ CI], 1.33- 2.63; P <. 001) or RFA ( HR, 1.88; 95% CI, 1.34- 2.65; P <. 001). In a preplanned substratification analysis, survival was also better in the TACE- RFA group than in the RFA group for patients with uninodular hepatocellular carcinoma ( HR, 2.50; 95% CI, 1.42- 4.42; P=. 001) and in the TACE- RFA group than the TACE group for patients with multinodular hepatocellular carcinoma ( HR, 1.99; 95% CI, 1.31- 3.00; P <. 001). The rate of objective response sustained for at least 6 months was higher in the TACE- RFA group ( 54%) than with either TACE ( 35%; rate difference, 0.19; 95% CI, 0.06- 0.33; P=. 009) or RFA ( 36%; rate difference, 0.18; 95% CI, 0.05- 0.32; P=. 01) treatment alone.; Conclusion In this patient group, TACE- RFA was superior to TACE alone or RFA alone in improving survival for patients with hepatocellular carcinoma larger than 3 cm.; Trial Registration clinicaltrials. gov Identifier: NCT00479050.