Xinjian Xu1,2, Changsheng Chen3, Qiang Liu4, Xiangzhong Huang5. 1. Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China. 2. Department of Interventional Radiology, Jiang yin people's hospital, No. 3, Yingrui Road, Jiangyin, 214400, Jiangsu, China. 3. Department of Human Resources, Department of Radiology, Jiang yin people's hospital, No. 3, Yingrui Road, Jiangyin, 214400, Jiangsu, China. 4. Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong, China. liuqiangdoc@163.com. 5. Department of Interventional Radiology, Jiang yin people's hospital, No. 3, Yingrui Road, Jiangyin, 214400, Jiangsu, China. hxzdoc@163.com.
Abstract
OBJECTIVES: To evaluate the efficacy and safety of TAE/TACE versus emergency surgery (ES) for spontaneous rupture of HCC (rHCC). METHODS: Eight databases (Web of Science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, Wanfang, CNKI and VIP) were searched to obtain all related literature from the inception dates to October 2019. Subgroup analyses based on the kind of study design and kind of embolization were conducted. RESULTS: Twenty-one studies comparing TAE/TACE with ES were eligible. A total of 974 rHCC participants (485 participants treated with TACE/TAE and 489 participants treated with ES) were included in the present meta-analysis. TAE/TACE group was associated with lower risk of complications (OR = 0.36; 95% CI, 0.22-0.57; P < 0.0001) and in-hospital mortality (OR = 0.52; 95% CI, 0.29-0.94; P = 0.03) compared with ES group. In addition, no significant difference in successful hemostasis (OR = 1.67; 95% CI, 0.85-3.28; P = 0.13) and 1-year survival (OR = 1.08; 95% CI, 0.79-1.48; P = 0.64) between TAE/TACE and ES groups was demonstrated. CONCLUSIONS: TAE/TACE had comparable outcomes to ES in terms of successful hemostasis and 1-year survival. Meanwhile, TAE/TACE was significantly superior to ES in terms of complications and in-hospital mortality. Therefore, TAE/TACE may be recommended as a preferable treatment for rHCC.
OBJECTIVES: To evaluate the efficacy and safety of TAE/TACE versus emergency surgery (ES) for spontaneous rupture of HCC (rHCC). METHODS: Eight databases (Web of Science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, Wanfang, CNKI and VIP) were searched to obtain all related literature from the inception dates to October 2019. Subgroup analyses based on the kind of study design and kind of embolization were conducted. RESULTS: Twenty-one studies comparing TAE/TACE with ES were eligible. A total of 974 rHCC participants (485 participants treated with TACE/TAE and 489 participants treated with ES) were included in the present meta-analysis. TAE/TACE group was associated with lower risk of complications (OR = 0.36; 95% CI, 0.22-0.57; P < 0.0001) and in-hospital mortality (OR = 0.52; 95% CI, 0.29-0.94; P = 0.03) compared with ES group. In addition, no significant difference in successful hemostasis (OR = 1.67; 95% CI, 0.85-3.28; P = 0.13) and 1-year survival (OR = 1.08; 95% CI, 0.79-1.48; P = 0.64) between TAE/TACE and ES groups was demonstrated. CONCLUSIONS:TAE/TACE had comparable outcomes to ES in terms of successful hemostasis and 1-year survival. Meanwhile, TAE/TACE was significantly superior to ES in terms of complications and in-hospital mortality. Therefore, TAE/TACE may be recommended as a preferable treatment for rHCC.