Department of Medical Oncology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan, China.
Intervention Clinic, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19 Xiuhua Road, Haikou, Hainan, 570000, China.
World J Surg Oncol. 2023 Sep 5;21(1):277. doi: 10.1186/s12957-023-03160-0.
The purpose of this study is to examine the impact of sequential transcatheter arterial chemoembolization (TACE) on the prognosis of patients with hepatocellular carcinoma (HCC) and microvascular invasion (MVI) following radical resection.
Five databases were searched for studies on the efficacy of TACE after radical hepatectomy resection (HR) for treating HCC with MVI. Depending on the heterogeneity between included studies, the relative risk (RR) and 95% confidence interval (CI) were computed using a random or fixed effect model.
Thirteen articles were included in this study. There were 1378 cases in the HR-TACE group (cases undergoing TACE after HR) and 1636 cases in the HR group (cases only undergoing HR). The recurrence-free survival (RFS) at 1 year, 2 years, 3 years, and 5 years after radical HCC resection was statistically significantly greater in the HR-TACE group than in the HR group. The HR-TACE group exhibited statistically significant advantages at 1-year, 2-year, 3-year, and 5-year overall survival (OS) after radical HCC resection when compared with the HR group.
Postoperative sequential TACE treatment can improve the RFS and OS rates at 1 year, 2 years, 3 years, and 5 years following radical HR in patients with HCC and MVI. These findings will guide clinicians in selecting appropriate cases for adjuvant TACE treatment during clinical diagnosis and treatment to maximize patient benefit.
PROSPERO CRD42023449238.
本研究旨在探讨序贯经导管动脉化疗栓塞（TACE）对根治性肝切除（HR）治疗伴有微血管侵犯（MVI）的肝细胞癌（HCC）患者预后的影响。
检索了五个数据库中关于 TACE 治疗伴 MVI 的 HCC 患者根治性肝切除术后（HR-TACE）疗效的研究。根据纳入研究之间的异质性，使用随机或固定效应模型计算相对风险（RR）和 95%置信区间（CI）。
本研究纳入了 13 篇文章。HR-TACE 组（HR 后行 TACE 治疗）有 1378 例，HR 组（仅行 HR）有 1636 例。根治性 HCC 切除术后 1 年、2 年、3 年和 5 年的无复发生存率（RFS）在 HR-TACE 组明显高于 HR 组。根治性 HCC 切除术后 1 年、2 年、3 年和 5 年的 HR-TACE 组总生存率（OS）明显优于 HR 组。
对于伴有 MVI 的 HCC 患者，根治性 HR 术后序贯 TACE 治疗可提高 1 年、2 年、3 年和 5 年的 RFS 和 OS 率。这些发现将指导临床医生在临床诊断和治疗中选择合适的病例进行辅助 TACE 治疗，以最大限度地提高患者的受益。
PROSPERO CRD42023449238。
