Adjuvant transarterial chemoembolization after curative resection for hepatocellular carcinoma with microvascular invasion: a meta-analysis

Q4 Medicine 中华肝胆外科杂志 Pub Date : 2020-01-28 DOI:10.3760/CMA.J.ISSN.1007-8118.2020.01.009

Jian Zhao, Jianbo Xu, Zhiying Gao, Jian-huai Zhang

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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 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. Key words: Carcinoma, hepatocellular; Hepatectomy; Transcatheter arterial chemoembolization; Microvascular invasion; Prognosis

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肝细胞癌伴微血管侵犯根治性切除术后辅助动脉化疗栓塞的荟萃分析

目的探讨肝细胞癌（HCC）及微血管侵犯（MVI）根治性切除术后辅助动脉化疗栓塞（TACE）的疗效。方法检索PubMed、Cochrane library、Embase、Web of Science、CNKI、VIP、万方等随机或非随机研究，比较HCC和MVI患者根治性切除术后使用或不使用术后辅助TACE的无复发生存率和总生存率。有限搜索时间为1999年1月1日至2019年5月1日。使用Stata（15.0版）和Review Manage（5.3版）软件进行统计分析。结果研究了8项研究，包括1809名患者。有815名患者接受了根治性肝切除术，994名患者没有接受术后辅助TACE。与不需要辅助TACE的患者相比，术后辅助TACE显著提高了HCC和MVI患者的无复发生存率和总生存率（HR=0.74，95%CI:0.65-0.85，P5cm仅在无复发存活率方面受益于术后辅助性TACE（HR=0.72，95%CI:0.58-0.90，P5cm）。这些结果需要在进一步的临床试验中得到验证。关键词：肝癌；肝切除术；经导管动脉化疗栓塞；微血管侵犯；预后

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来源期刊

中华肝胆外科杂志 Medicine-Gastroenterology

CiteScore

0.20

自引率

0.00%

发文量

7101

期刊介绍： Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.