Huang Xiaozhun, Jia Chenyang, Xu Lin, Bi Xinyu, Lai Fengyong, Huang Zhangkan, Li Xiaoqing, Yin Xin, Ni Yong, Che Xu
Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
Department of Hepatopancreatobiliary Surgery, Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Front Oncol. 2022 May 19;12:877091. doi: 10.3389/fonc.2022.877091. eCollection 2022.
The spontaneous rupture of hepatocellular carcinoma (HCC) is associated with high mortality rates, and liver resection can provide better outcomes than other available treatments. However, the survival length of patients subjected to hepatectomy after spontaneous rupture of hepatocellular carcinoma remains controversial.
Articles reporting the comparison of the survival outcome between patients with rupture HCC (rHCC) and non-rupture HCC (nrHCC) from the inception until December 31, 2021 by PubMed, Web of Science, OVID, and the Cochrane Library databases were included. The high-quality propensity score matching analysis was used to investigate the impact of rupture on disease-free survival (DFS) and overall survival (OS) between the rHCC and nrHCC group with no heterogeneity.
A total of 606 patients from six cohort studies were included. The major baseline characteristics of the eligible patients were well balanced between rHCC and nrHCC group. The 1-, 3-, and 5-year hazard ratios of DFS were 3.45 (95% confidence interval [CI] 2.54-4.68), 3.63 (95% CI 2.87-4.60), and 3.72 (95% CI 2.93-4.72), respectively. The 1-, 3-, and 5-year hazard ratios of OS were 5.01 (95% CI 3.26-7.69), 5.49 (95% CI 4.08-7.39), and 4.20 (95% CI 3.20-5.51), respectively.
The present meta-analysis demonstrated that the DSF and OS were significantly shorter in the rHCC group than in the nrHCC group, thus revealing that spontaneous HCC rupture was a predictor of poor survival.
肝细胞癌（HCC）自发性破裂与高死亡率相关，肝切除术比其他现有治疗方法能提供更好的治疗效果。然而，肝细胞癌自发性破裂后接受肝切除术患者的生存时长仍存在争议。
纳入通过PubMed、科学网、OVID和Cochrane图书馆数据库报告的从开始至2021年12月31日期间破裂性肝癌（rHCC）患者与非破裂性肝癌（nrHCC）患者生存结局比较的文章。采用高质量倾向评分匹配分析来研究破裂对rHCC组和nrHCC组无差异的无病生存期（DFS）和总生存期（OS）的影响。
共纳入来自六项队列研究的606例患者。符合条件患者的主要基线特征在rHCC组和nrHCC组之间均衡良好。DFS的1年、3年和5年风险比分别为3.45（95%置信区间[CI] 2.54 - 4.68）、3.63（95% CI 2.87 - 4.60）和3.72（95% CI 2.93 - 4.72）。OS的1年、3年和5年风险比分别为5.01（95% CI 3.26 - 7.69）、5.49（95% CI 4.08 - 7.39）和4.20（95% CI 3.20 - 5.51）。
本荟萃分析表明，rHCC组的DSF和OS明显短于nrHCC组，从而揭示肝细胞癌自发性破裂是生存不良的一个预测因素。
