BMC Gastroenterology | |
Transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus: a meta-analysis | |
Research Article | |
Xin Yin1  Tong-Chun Xue1  Zheng-Gang Ren1  Xiao-Ying Xie1  Lan Zhang1  Bo-Heng Zhang2  | |
[1] Liver Cancer Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, P.R. China;Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai, P.R. China;Liver Cancer Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, P.R. China;Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, Shanghai, P.R. China;Department of Medical Statistics, Zhongshan Hospital, Fudan University, Shanghai, P.R. China; | |
关键词: Chemoembolization; Hepatocellular carcinoma; Portal vein; Embolus; Meta-analysis; | |
DOI : 10.1186/1471-230X-13-60 | |
received in 2012-11-25, accepted in 2013-03-20, 发布年份 2013 | |
来源: Springer | |
【 摘 要 】
BackgroundAlthough transarterial chemoembolization (TACE) has been used extensively for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), no consensus has been reached and an evidence base for practice is lacking. This meta-analysis evaluated the efficacy and safety of TACE for treatment of HCC with PVTT.MethodsOvid Medline, EMBASE, Web of Knowledge, and Cochrane library databases were searched up to August 2012 for controlled trials assessing TACE in patients with PVTT. Data concerning the study design, characteristics of trials, and outcomes were extracted. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using random effects models.ResultsEight controlled trials involving 1601 HCC patients were included. TACE significantly improved the 6-month (HR, 0.41; 95% CI: 0.32–0.53; z, 6.28; p = 0.000) and 1-year (HR, 0.44; 95% CI: 0.34–0.57; z, 6.22; p = 0.000) overall survival of patients with PVTT compared with conservative treatment. Subgroup analyses showed that TACE was significantly effective in HCC patients whether with main portal vein (MPV) obstruction or with segmental PVTT. Fatal complications were rare, even in patients with MPV obstruction. Temporary liver decompensation and postembolization syndrome occurred frequently. However, they could be treated successfully with conservative treatment.ConclusionsTACE, as a safe treatment, has potential for incurring a survival benefit for advanced HCC with PVTT, even with MPV obstruction. Further large randomized controlled trials may be needed to confirm this result.
【 授权许可】
Unknown
© Xue et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
【 预 览 】
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【 参考文献 】
- [1]
- [2]
- [3]
- [4]
- [5]
- [6]
- [7]
- [8]
- [9]
- [10]
- [11]
- [12]
- [13]
- [14]
- [15]
- [16]
- [17]
- [18]
- [19]
- [20]