Hepatic Re-resection Versus Transarterial Chemoembolization for the Treatment of Recurrent Hepatocellular Carcinoma after Initial Resection: a Systematic Review and Meta-analysis

Wang, Di-Ya; Liu, Lei; Qi, Xing-Shun; Su, Chun-Ping; Chen, Xue; Liu, Xu; Chen, Jiang; Li, Hong-Yu; Guo, Xiao-Zhong

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자료유형: 학술저널

저자정보: Wang, Di-Ya (Department of Occupational and Environmental Health Sciences and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Hea) Liu, Lei (Xijing Hospital of Digestive Diseases, Fourth Military Medical University) Qi, Xing-Shun (Department of Gastroenterology, General Hospital of Shenyang Military Area) Su, Chun-Ping (Library of Fourth Military Medical University) Chen, Xue (Department of Gastroenterology, General Hospital of Shenyang Military Area) Liu, Xu (Department of Gastroenterology, General Hospital of Shenyang Military Area) Chen, Jiang (Department of Gastroenterology, General Hospital of Shenyang Military Area) Li, Hong-Yu (Department of Gastroenterology, General Hospital of Shenyang Military Area) Guo, Xiao-Zhong (Department of Gastroenterology, General Hospital of Shenyang Military Area)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제16권 제13호

발행연도: 2015.1

수록면: 5,573 - 5,578 (6page)

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Background: A systematic review and meta-analysis were performed to compare the post-recurrence survival with hepatic re-resection versus transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after initial resection. Materials and Methods: All relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analysis was performed according to country. Sensitivity analysis was performed in studies which clearly reported the recurrent regions, in moderate/high-quality studies, in studies published in full-text form, and in studies published after 2005. Results: In total, twelve papers were included in our study. Five and seven of them were of moderate- and poor-quality, respectively. The overall meta-analysis demonstrated a statistically significantly higher post-recurrence survival in the hepatic re-resection group than in those undergoing TACE (HR=0.64, 95%CI=0.52-0.79, P<0.0001). Heterogeneity was statistically significant and statistical significance remained in the subgroup analysis. Sensitivity analyses were also consistent with the overall analysis. Conclusions: Hepatic re-resection might provide a better post-recurrence survival than TACE for recurrent HCC after initial resection. However, considering the low quality of published studies and the potential bias of treatment selection, further randomized trials should be warranted to confirm these findings.

#Hepatocellular carcinoma #resection #transarterial chemoembolization #recurrence #survival

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Wang, Di-Ya

소속기관 Department of Occupational and Environmental Health Sciences and the Ministry of Education Key Lab o