TACE combined with hepatectomy in the treatment of primary hepatocellular carcinoma: A Meta analysis / 中华普通外科杂志

ABSTRACT

Objective To evaluate the therapeutic effects of preoperative prophylactic TACE for resectable primary hepatocellular carcinoma patients by mata analysis.Methods The research was conducted by retrieving China biomedical literature database,Chinese CNKI,VIP,Wanfang and PubMed,OVID,Embase,Cochrane library.Randomized controlled trials were evaluated by using the modified Jadad score and the case-control study were evaluated by using the Newcastle-Ottawa Scale respectively.All trials involved were analyzed by Stata12.0.Results 2 316 patients came from 3 randomized controlled trials (RCT) and 8 case-control articles including 752 patients in preoperative prophylactic TACE groups and 1 564 patients from liver resection only group.There was no significant difference in the operation time and blood loss between the two groups (operation time:SMD =0.058,95 ％ CI:-0.166-0.050,P =0.290;the amount of bleeding:SMD =-0.098,95 ％ CI:-0.204--0.08,P =0.070).The hospital stay was slightly prolonged in the preoperative prophylactic TACE groups (SMD =-0.86,95％ CI:-1.57--0.14,P =0.02).There was no significant difference between two groups in the 3-year overall survival and 5-year overall survival (the 3-year overall survival:RR =1.039,95％ CI:0.964-1.121,P =0.314;the 5-year overall survival:RR =0.96,95％ CI:0.86-1.08,P =0.505).Conclusion The Preoperative TACE fails to reduce the operation time and intraoperative blood loss,only prolonging the length of hospital stay.While the long-term survival rate remained unimproved.