Clinical efficacy of liver venous deprivation versus portal vein embolization in treatment of liver cancer with insufficient residual liver volume： A Meta-analysis
- VernacularTitle:肝静脉剥夺术与门静脉栓塞治疗剩余肝体积不足肝癌效果比较的Meta分析
- Author:
Kaifeng YAN
1
;
Xiaojie HU
1
;
Hong LIU
2
Author Information
- Publication Type:Journal Article
- Keywords: Liver Neoplasms; Liver Vein Deprivation; Portal Vein Embolism; Meta-Analysis
- From: Journal of Clinical Hepatology 2024;40(12):2464-2472
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo systematically evaluate the efficacy and prognosis of liver venous deprivation （LVD） versus portal vein embolization （PVE） in the treatment of hepatic malignancies with insufficient residual liver volume. MethodsThis study was conducted according to PRISMA guidelines， with a PROSPERO registration number of CRD42024533292. Databases including PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， and VIP were searched for articles on the efficacy of LVD versus PVE. According to the inclusion and exclusion criteria， related articles were screened for quality assessment and extraction of clinical data for LVD and PVE， and related data were summarized and analyzed. RevMan 5.3 was used to perform the Meta-analysis. ResultsA total of 12 articles （all cohort studies） were included， involving 644 patients （245 in the LVD group and 399 in the PVE group）. The Meta-analysis showed that there were significant differences between the two groups in FLR growth rate after embolization （standardized mean difference ［SMD］=0.84， 95% confidence interval ［CI］： 0.59 — 1.09， P<0.05）， daily growth volume of FLR after embolization （SMD=1.19， 95%CI： 0.64 — 1.73， P<0.05）， the incidence rate of complications after embolization （risk ratio ［RR］=1.59， 95%CI： 1.06 — 2.38， P<0.05）， interval between embolization and second-stage surgery （SMD=-0.81， 95%CI： -1.32 to -0.29， P<0.05）， and the completion rate of second-stage surgery （RR=1.09， 95%CI： 1.01 — 1.18， P<0.05）. ConclusionCompared with PVE， LVD can enable patients to achieve FLR for surgery in a relatively short period of time， thereby reducing the incidence rate of disease progression， solving the problem of hypertrophic deficiency， achieving a higher second-stage surgical resection rate， and bringing more benefits to patients with liver cancer. In addition， LVD has similar safety profiles to PVE during second-stage surgery.
