Adjuvant transarterial chemoembolization after curative resection for hepatocellular carcinoma with microvascular invasion: a meta-analysis
10.3760/cma.j.issn.1007-8118.2020.01.009
- VernacularTitle:肝细胞癌合并微血管侵犯肝切除术后辅助性TACE疗效的荟萃分析
- Author:
Jian ZHAO
1
;
Jianbo XU
;
Zhiying GAO
;
Jianhuai ZHANG
Author Information
1. 南京医科大学附属淮安第一医院肝胆外科
- Keywords:
[Key word] Carcinoma,hepatocellular;
Hepatectomy;
Transcatheter arterial chemoembolization;
Microvascular invasion;
Prognosis
- From:
Chinese Journal of Hepatobiliary Surgery
2020;26(1):38-43
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the impact of adjuvant transarterial chemoembolization (TACE)after curative resection for patients with hepatocellular carcinoma (HCC) and microvascular invasion (MVI).Methods PubMed,Cochrane library,Embase,Web of Science,CNKI,VIP,Wanfang were searched for randomized or non-randomized studies which compared recurrence-free survival and overall survival rates with or without postoperative adjuvant TACE after curative resection for patients with HCC and MVI.The limited search time was from January 1st,1999 to May 1st,2019.Statistical analyses were performed with software programs using Stata (version 15.0) and Review Manage (version 5.3).Results Eight studies which included 1 809 patients were studied.There were 815 patients who received and 994 patients who did not receive postoperative adjuvant TACE after radical hepatectomy.Postoperative adjuvant TACE significantly improved recurrence-free survival and overall survival rates in patients with HCC and MVI when compared with the patients who required no adjuvant TACE (HR =0.74,95％ CI:0.65-0.85,P ＜0.05;HR =0.74,95％ CI:0.62-0.89,P ＜ 0.05,respectively).Subgroup analysis demonstrated that patients with tumor diameter ＞ 5 cm benefited from postoperative adjuvant TACE only in recurrence-free survival rate (HR =0.72,95％ CI:0.58-0.90,P ＜ 0.05),but not in overall survival rate.Conclusion Postoperative adjuvant TACE delayed recurrence of microvascular invasion of HCC and improved long-term prognosis,but not for tumors with diameter ＞5 cm.These results need to be validated in further clinical trials.
