代谢功能障碍相关脂肪性肝病与其他病因导致的肝细胞癌的肝移植对比:荟萃分析

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Alessandro Parente, Flavio Milana, Shahin Hajibandeh, Shahab Hajibandeh, Krishna V Menon, Ki-Hun Kim, A M James Shapiro, Andrea Schlegel
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引用次数: 0

摘要

背景和目的:因代谢功能障碍相关性脂肪性肝病(MASLD)导致的肝细胞癌(HCC)而进行肝移植的患者越来越多,而且预计会进一步增加。我们比较了MASLD相关HCC与其他病因(OE)移植的结果:对数据库进行检索,以确定比较 MASLD 相关 HCC 与 OE 相关 HCC 移植后疗效的研究。采用随机效应模型对研究数据进行汇总。使用总生存期(OS)的危险比(HR)和1、3、5年OS和无病生存期(DFS)的几率比(OR)分析生存结果:结果:共发现10项回顾性比较研究,包括51 761例患者(MASLD相关HCC=6 793例,OE相关HCC=44 968例)。在平均生存时间(HR:0.93, CI95 % 0.81-1.07,p = 0.29)、1年(87.6% vs 88 %;OR:1.15; CI95 %0.73-1.79,p = 0.55)、3年(77.2% vs 76%;OR:1.36;CI95 %0.96-1.94,p = 0.08)或5年(67.7% vs 66.3%;OR:1.08;CI95 %0.77-1.53,p = 0.65)OS率。1年(87.9% vs. 87%;OR:1.07,p = 0.62)、3年(77.6% vs. 73.6%;OR:1.66,p = 0.13)和5年(68% vs. 65.6%;OR:1.37,p = 0.39)的DFS相当:这项对现有最佳证据(2a 级)的荟萃分析表明,MASLD 相关 HCC 和 OE 相关 HCC 的肝移植存活率相当。鉴于作为移植适应症的MASLD相关HCC在全球呈上升趋势,因此需要在欧洲和亚洲等其他大洲进行更大规模的研究,以证实我们的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Liver transplant for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease versus other etiologies: A meta-analysis.

Background & aims: Liver transplantation for hepatocellular carcinoma (HCC) in metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly being diagnosed and predicted to rise further. We compared outcomes of transplantation for MASLD-related HCC versus other etiologies (OE).

Methods: Databases were searched to identify studies comparing outcomes after transplantation MASLD-related HCC with OE-related HCC. Study data were pooled using random-effects modelling. Survival outcomes were analyzed using hazard ratio (HR) for overall survival (OS) and odds ratio (OR) for 1-,3-, and 5-years OS and disease-free survival (DFS).

Results: Ten retrospective comparative studies were identified including a total number of 51'761 patients (MASLD-related HCC=6'793, OE-related HCC=44'968). There were no significant differences in time-to-even survival (HR:0.93, CI95 % 0.81-1.07,p = 0.29), 1-year (87.6% vs 88 %;OR:1.15; CI95 %0.73-1.79,p = 0.55), 3-year (77.2% vs 76 %;OR:1.36;CI95 %0.96-1.94,p = 0.08), or 5-year (67.7% vs 66.3 %;OR:1.08; CI95 %0.77-1.53,p = 0.65) OS rates between the groups. DFS was comparable at 1-year (87.9% vs. 87 %; OR:1.07,p = 0.62), 3-years (77.6% vs. 73.6 %;OR:1.66,p = 0.13) and 5-year (68% vs. 65.6 %;OR:1.37,p = 0.39).

Conclusion: This meta-analysis of the best available evidence (Level 2a) demonstrated that liver transplantation for MASLD-related and OE-related HCC has comparable survival outcomes. Given the global rise in MASLD-related HCC as indication for transplantation, larger studies from other continents, including Europe and Asia, are needed to confirm our findings.

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来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
期刊介绍: Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.
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