Lei Liang1, Ting-Hao Chen2, Chao Li1, Hao Xing1, Jun Han1, Ming-Da Wang1, Han Zhang1, Wan Yee Lau3, Meng-Chao Wu1, Feng Shen4, Tian Yang5. 1. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China. 2. Department of General Surgery, Ziyang First People's Hospital, Sichuan, China. 3. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. 4. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China. Electronic address: fengshensmmu@gmail.com. 5. Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China. Electronic address: yangtiandfgd@hotmail.com.
Abstract
BACKGROUND: The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is very poor. According to most HCC guidelines, sorafenib, transarterial chemoembolization (TACE) or other non-surgical treatments are recommended as the first-line therapy for these patients. However, selected patients with HCC and PVTT can undergo surgical resection (SR). The aim of this meta-analysis was to compare the outcomes of SR with Non-SR for such patients. METHODS: The PubMed, Embase, Medline and Cochrane library were searched for studies which compared SR with Non-SR for HCC and PVTT published before December 2017. RESULTS: 4810 patients from 7 studies who were enrolled in this meta-analysis were divided into the SR group (n = 2 344, 49%) and the Non-SR group (n = 2 476, 51%). The pooled hazard ratios (HRs) for the 1-, 3- and 5-year OS rates of the SR group when compared with the Non-SR group, were 0.57 (95% CI 0.48-0.67, P <0.001), 0.66 (95% CI 0.56-0.77, P <0.001) and 0.68 (95% CI 0.57-0.81, P <0.001), respectively. On subgroup analysis, the pooled HRs for the 1-, 3- and 5-year OS rates of the SR group when compared with the TACE group, were 0.62 (95% CI 0.54-0.71, P <0.001), 0.74 (95% CI 0.66-0.83, P <0.001) and 0.78 (95% CI 0.70-0.87, P <0.001), respectively. CONCLUSION: This meta-analysis showed SR resulted in better OS than TACE, or other Non-SR treatments, for patients with HCC and PVTT. SR should be considered in selected patients with resectable HCC and PVTT.
BACKGROUND: The prognosis of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) is very poor. According to most HCC guidelines, sorafenib, transarterial chemoembolization (TACE) or other non-surgical treatments are recommended as the first-line therapy for these patients. However, selected patients with HCC and PVTT can undergo surgical resection (SR). The aim of this meta-analysis was to compare the outcomes of SR with Non-SR for such patients. METHODS: The PubMed, Embase, Medline and Cochrane library were searched for studies which compared SR with Non-SR for HCC and PVTT published before December 2017. RESULTS: 4810 patients from 7 studies who were enrolled in this meta-analysis were divided into the SR group (n = 2 344, 49%) and the Non-SR group (n = 2 476, 51%). The pooled hazard ratios (HRs) for the 1-, 3- and 5-year OS rates of the SR group when compared with the Non-SR group, were 0.57 (95% CI 0.48-0.67, P <0.001), 0.66 (95% CI 0.56-0.77, P <0.001) and 0.68 (95% CI 0.57-0.81, P <0.001), respectively. On subgroup analysis, the pooled HRs for the 1-, 3- and 5-year OS rates of the SR group when compared with the TACE group, were 0.62 (95% CI 0.54-0.71, P <0.001), 0.74 (95% CI 0.66-0.83, P <0.001) and 0.78 (95% CI 0.70-0.87, P <0.001), respectively. CONCLUSION: This meta-analysis showed SR resulted in better OS than TACE, or other Non-SR treatments, for patients with HCC and PVTT. SR should be considered in selected patients with resectable HCC and PVTT.
Authors: Aline Mähringer-Kunz; Verena Steinle; Roman Kloeckner; Sebastian Schotten; Felix Hahn; Irene Schmidtmann; Jan Bernd Hinrichs; Christoph Düber; Peter Robert Galle; Hauke Lang; Arndt Weinmann Journal: PLoS One Date: 2021-05-07 Impact factor: 3.240
Authors: Emily L Ryon; Joshua P Kronenfeld; Rachel M Lee; Adam Yopp; Annie Wang; Ann Y Lee; Sommer Luu; Cary Hsu; Eric Silberfein; Maria C Russell; Neha Goel; Nipun B Merchant; Jashodeep Datta Journal: J Surg Oncol Date: 2020-10-30 Impact factor: 3.454