Meta-analysis of treatment strategies for post-hepatectomy recurrent hepatocellular carcinoma:salvage liver transplantation or repeat hepatectomy / 中华肝胆外科杂志

ABSTRACT

Objective To evaluate the effectiveness of salvage liver transplantation ( SLT) versus repeat hepatectomy (RH) in post-hepatectomy recurrent hepatocellular carcinoma. Methods Data from 1 January 1990 to 31 July 2018 were retrieved from the Cochrane library, PubMed, EMbase, Wan Fang Data, CBM, CNKI, VIP and other databases. The collected publications were all on case-control studies comparing SLT with RH for post-hepatectomy recurrent hepatocellular carcinoma. The literatures’ quality and the data of each study were evaluated and analyzed using RevMan. Relative risk (RR) and 95% confidence interval (CI) were used. Results Five articles which included 525 patients were enrolled. There were no signifi-cant differences between SLT and RH on the 1-, 3-and 5-year overall survival (P＞0. 05 for all). Howev-er, for the 1-year (RR=2. 86, 95% CI 1. 37～5. 97, P＜0. 05), 3-year (RR=2. 57, 95% CI 0. 99～6. 70, P=0. 05), and 5-year disease-free survivals (RR=4. 79, 95% CI 1. 88～12. 25, P＜0. 05), PLT was significantly better than RH. Conclusion The effectiveness of SLT was superior to RH in the treatment of post-heptectomy recurrent hepatocellular carcinoma. However, considering the similar overall survival rates, RH is still an important treatment option for post-hepatectomy recurrent hepatocellular carcinoma because of liver donor shortage.