Francisco Tustumi , Fabricio Ferreira Coelho , Daniel de Paiva Magalhães , Sérgio Silveira Júnior , Vagner Birk Jeismann , Gilton Marques Fonseca , Jaime Arthur Pirola Kruger , Luiz Augusto Carneiro D'Albuquerque , Paulo Herman
{"title":"肝细胞癌伴宏观血管侵犯的治疗:系统回顾和网络荟萃分析","authors":"Francisco Tustumi , Fabricio Ferreira Coelho , Daniel de Paiva Magalhães , Sérgio Silveira Júnior , Vagner Birk Jeismann , Gilton Marques Fonseca , Jaime Arthur Pirola Kruger , Luiz Augusto Carneiro D'Albuquerque , Paulo Herman","doi":"10.1016/j.trre.2023.100763","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate the outcomes of different treatments for patients with hepatocellular carcinoma (HCC) and macroscopic vascular invasion.</p></div><div><h3>Methods</h3><p><span>A systematic review<span><span> and meta-analysis of comparative studies was performed to evaluate various treatment modalities for HCC with macroscopic vascular invasion, including liver resection (LR), </span>liver transplantation<span> (LT), transarterial chemoembolization<span> (TACE), transarterial radioembolization (TARE), radiotherapy (RT), </span></span></span></span>radiofrequency ablation<span> (RFA), and antineoplastic systemic therapy (AnST).</span></p></div><div><h3>Results</h3><p>After applying the selection criteria, 31 studies were included. The surgical resection (SR) group (including LR and LT) had a similar mortality rate to the non-surgical resection (NS) group (RD = −0.01; 95% CI -0.05 to 0.03). The SR group had a higher rate of complications (RD = 0.06; 95% CI 0.00 to 0.12) but a higher 3-year overall survival (OS) rate than the NS group (RD = 0.12; 95% CI 0.05 to 0.20). The network analysis revealed that the overall survival was lower in the AnST group. LT and LR had similar survival benefits. The meta-regression suggested that SR has a greater impact on the survival of patients with impaired liver function.</p></div><div><h3>Discussion</h3><p>Most likely, LT has a significant impact on long-term survival and consequently would be a better option for HCC with macroscopic vascular invasion in patients with impaired liver function. LT and LR offer a higher chance of long-term survival than NS alternatives, although LR and LR are associated with a higher risk of procedure-related complications.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100763"},"PeriodicalIF":3.6000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment of hepatocellular carcinoma with macroscopic vascular invasion: A systematic review and network meta-analysis\",\"authors\":\"Francisco Tustumi , Fabricio Ferreira Coelho , Daniel de Paiva Magalhães , Sérgio Silveira Júnior , Vagner Birk Jeismann , Gilton Marques Fonseca , Jaime Arthur Pirola Kruger , Luiz Augusto Carneiro D'Albuquerque , Paulo Herman\",\"doi\":\"10.1016/j.trre.2023.100763\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This study aimed to evaluate the outcomes of different treatments for patients with hepatocellular carcinoma (HCC) and macroscopic vascular invasion.</p></div><div><h3>Methods</h3><p><span>A systematic review<span><span> and meta-analysis of comparative studies was performed to evaluate various treatment modalities for HCC with macroscopic vascular invasion, including liver resection (LR), </span>liver transplantation<span> (LT), transarterial chemoembolization<span> (TACE), transarterial radioembolization (TARE), radiotherapy (RT), </span></span></span></span>radiofrequency ablation<span> (RFA), and antineoplastic systemic therapy (AnST).</span></p></div><div><h3>Results</h3><p>After applying the selection criteria, 31 studies were included. The surgical resection (SR) group (including LR and LT) had a similar mortality rate to the non-surgical resection (NS) group (RD = −0.01; 95% CI -0.05 to 0.03). The SR group had a higher rate of complications (RD = 0.06; 95% CI 0.00 to 0.12) but a higher 3-year overall survival (OS) rate than the NS group (RD = 0.12; 95% CI 0.05 to 0.20). The network analysis revealed that the overall survival was lower in the AnST group. LT and LR had similar survival benefits. The meta-regression suggested that SR has a greater impact on the survival of patients with impaired liver function.</p></div><div><h3>Discussion</h3><p>Most likely, LT has a significant impact on long-term survival and consequently would be a better option for HCC with macroscopic vascular invasion in patients with impaired liver function. LT and LR offer a higher chance of long-term survival than NS alternatives, although LR and LR are associated with a higher risk of procedure-related complications.</p></div>\",\"PeriodicalId\":48973,\"journal\":{\"name\":\"Transplantation Reviews\",\"volume\":\"37 3\",\"pages\":\"Article 100763\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0955470X23000174\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0955470X23000174","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Treatment of hepatocellular carcinoma with macroscopic vascular invasion: A systematic review and network meta-analysis
Background
This study aimed to evaluate the outcomes of different treatments for patients with hepatocellular carcinoma (HCC) and macroscopic vascular invasion.
Methods
A systematic review and meta-analysis of comparative studies was performed to evaluate various treatment modalities for HCC with macroscopic vascular invasion, including liver resection (LR), liver transplantation (LT), transarterial chemoembolization (TACE), transarterial radioembolization (TARE), radiotherapy (RT), radiofrequency ablation (RFA), and antineoplastic systemic therapy (AnST).
Results
After applying the selection criteria, 31 studies were included. The surgical resection (SR) group (including LR and LT) had a similar mortality rate to the non-surgical resection (NS) group (RD = −0.01; 95% CI -0.05 to 0.03). The SR group had a higher rate of complications (RD = 0.06; 95% CI 0.00 to 0.12) but a higher 3-year overall survival (OS) rate than the NS group (RD = 0.12; 95% CI 0.05 to 0.20). The network analysis revealed that the overall survival was lower in the AnST group. LT and LR had similar survival benefits. The meta-regression suggested that SR has a greater impact on the survival of patients with impaired liver function.
Discussion
Most likely, LT has a significant impact on long-term survival and consequently would be a better option for HCC with macroscopic vascular invasion in patients with impaired liver function. LT and LR offer a higher chance of long-term survival than NS alternatives, although LR and LR are associated with a higher risk of procedure-related complications.
期刊介绍：
Transplantation Reviews contains state-of-the-art review articles on both clinical and experimental transplantation. The journal features invited articles by authorities in immunology, transplantation medicine and surgery.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
