肝细胞癌肝大部分切除术前序贯TACE和门静脉栓塞与单独门静脉栓塞的比较：系统评价和荟萃分析

目的比较序贯经导管动脉化疗栓塞（TACE）和门静脉栓塞（PVE）与单独PVE在肝细胞癌（HCC）患者肝大部分切除术前的有效性和安全性。 方法对PubMed、Cochrane图书馆进行检索。主要终点包括总生存率（OSR）、无复发生存率（RFSR）、残肝体积百分比（FLR）的增加；次要终点包括肝切除率、术后并发症、术后肝功能衰竭率和术后死亡率。 结果共纳入了五项回顾性研究。结果显示，TACE + PVE组与PVE组相比，具有较高的1年OSR、3年OSR、5年OSR以及10年OSR。结果还表明，TACE + PVE组与PVE组相比，具有较高的1年RFSR、3年RFSR、5年RFSR以及10年RFSR。此外，TACE + PVE组与PVE组相比，具有更高的FLR体积、更高的肝切除率以及较低的术后并发症。 结论在肝大部分切除术前，对于HCC患者来说，序贯TACE和PVE似乎是比单独PVE更有效的治疗方法，具有更好的生存率和安全性。

Comparison of sequential TACE and portal vein embolization with portal vein embolization alone before major hepatectomy in hepatocellular carcinoma: a systematic review and meta-analysis

ObjectiveCompare the efficiency and safety of sequential transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) versus PVE alone before major hepatectomy for patients with hepatocellular carcinoma (HCC). MethodsPubMed, the Cochrane Library were screened. The primary endpoints were overall survival rate (OSR), recurrence-free survival rate (RFSR), the increase in the percentage of FLR volume; secondary endpoints were hepatectomy rate, postoperative complications, hepatic failure rate after surgery, and mortality after surgery. ResultsA total of five retrospective studies were included. The results showed the TACE + PVE group had a higher 1-year OSR, 3-year OSR, 5-year OSR, and 10-year OSR than PVE group. The results also indicated the TACE + PVE group had a higher 1-year RFSR, 3-year RFSR, 5-year RFSR, and 10-year RFSR than PVE group. The results demonstrated the TACE + PVE group had a higher FLR volume, as well as higher hepatectomy rate, and lower postoperative complications than PVE group. ConclusionsSequential TACE and PVE seem to be a more effective therapy than PVE alone before major hepatectomy for HCC patients, with better survival and safety.