A systematic review comparing outcomes of surgical resection and non-surgical treatments for patients with hepatocellular carcinoma and portal vein tumor thrombus

作者：Lei Liang; Ting-Hao Chen; Chao Li; Hao Xing; Jun Han; Ming-Da Wang; Han Zhang; Wan Yee Lau; Meng-Chao Wu; Feng Shen; Tian Yang

来源：Hepato Pancreato Biliary, 2018, 20(12): 1119-1129.

DOI：10.1016/j.hpb.2018.06.1804

Background(#br)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.(#br)Methods(#br)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.(#br)Results(#br)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 \u003c 0.001 ), 0.66 (95% CI 0.56–0.77, P \u003c 0.001 ) and 0.68 (95% CI 0.57–0.81, P \u003c 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 \u003c 0.001 ), 0.74 (95% CI 0.66–0.83, P \u003c 0.001 ) and 0.78 (95% CI 0.70–0.87, P \u003c 0.001 ), respectively.(#br)Conclusion(#br)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.

• 出版日期2018
• 单位中国人民解放军第二军医大学