| Institution: | 1. Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China;2. Academician (Expert) Workstation of Sichuan Province, Luzhou, 646000, China;3. Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, China;4. Department of General Surgery (Thyroid Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China;5. Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, China;1. Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France;2. AP-HP.CUP, Department of gynecological and breast cancer surgery, Georges-Pompidou European Hospital, Paris, France;3. Department of Gynaecology. CHRU de Tours. Hôpital Bretonneau. INSERM Unit, 1069, 2 boulevard Tonnellé 37044, Tours, France;4. Department of Gynaecologic and Oncologic Surgery and Obstetrics, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Université Lyon 1, France;5. Department of Gynaecologic and Breast Surgery, Groupe Hospitalier Diaconesses Croix Saint Simon, 125 rue d’Avron, 75020, Paris, France;6. APHP. Service de gynécologie & obstétrique, GH Saint-Louis Lariboisière-Fernand Widal, Hôpital Lariboisière, Université de Paris, 2, rue Ambroise Paré, 75010, Paris, France;7. Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France;8. Department of Obstetrics and Gynaecology, Alix de Champagne Institute, Centre Hospitalier Universitaire, 45 rue Cognacq-Jay, 51092, Reims, France;9. Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, 13397, Marseille, France;10. Department of Gynaecology, CHU de Rennes, France;11. INSERM, 1242, COSS, Rennes, Université de Rennes 1, France;12. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France;13. Department of Gynecologic and Breast Surgery and Oncology, Hôpital la Pitié Salpétrière, AP-HP, Paris, France;14. Department of Gynaecology and Obstetrics, Hôpital Bichat, AP-HP, France;15. Department of Gynaecology and Obstetrics, CHU de Clermont Ferrand, France;1. Department of GI Surgery, Ghent University Hospital, Ghent, Belgium;2. Cancer Research Institute Ghent (CRIG), Belgium;1. Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, Jilin, China;2. School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China |
| Abstract: | Background/aimThe Barcelona Clinic Liver Cancer (BCLC) recommends that transcatheter arterial chemoembolization (TACE) are indicated in patients with multiple hepatocellular carcinomas (HCCs) of BCLC-B stage. However, partial hepatectomy (PH) has increasely performed in these patients. The purpose of this meta-analyses is to illustrate the comparative survival benefits of PH and TACE for patients with multiple HCCs of BCLC-B stage.MethodElectronic databases were systematically searched for eligible studies that compared PH and TACE performed in patients with multiple HCCs of BCLC-B stage. Studies that met the inclusion criteria were reviewed systematically. The reported data were aggregated statistically using the RevMan5.3 software. Primary endpoint was overall survival (OS), and secondary endpoint were the 1-, 3-, and 5-year survival rates, postoperative 30-day mortality and postoperative complications.ResultsA total of seven high-quality studies (one randomized controlled trial RCT], six propensity-score matching (PSM) nonrandomized comparative trials non-RCTs] that met the inclusion criteria, which comprised of 2487 patients (1245 PH and 1242 TACE) in the meta-analysis. When compared with the TACE group, the PH group had a significantly higher OS (HR, 1.65; 95% CI, 1.48–1.84; P = 0.26; I2 = 22%) and 1-, 3-, 5-year survival rates (OR, 1.96; 95% CI, 1.59–2.41; P = 0.0005; I2 = 75%; P < 0.00001; OR, 2.92; 95% CI, 1.94–4.42; P = 0.0001; I2 = 78%; P < 0.00001; OR, 2.60; 95% CI, 2.17–3.11; P = 0.13; I2 = 44%; P < 0.00001; respectively). Survival benefits persisted across sensitivity and subgroup analyses; High heterogeneity remained after sensitivity and subgroup analyses for 3-year survival rates.ConclusionPH can provide more survival benefit for patients with multiple HCCs of BCLC-B stage compared with TACE. |
