Postoperativer TACE in hepatocellular carcinoma: a Meta-analysis / 中华肝胆外科杂志

ABSTRACT

Objective To evaluate the therapeutic effects of postoperative TACE (transarterial chemoembolization) in patients with hepatocellular carcinoma after liver resection.Methods The search was conducted on China biomedical literature database,Chinese CNKI,VIP,Wanfang and PubMed,OVID,Embase and Cochrane library.All the literatures were searched till the end of January 2016.The quality of the included studies were evaluated using the modified Jadad score for randomized controlled trials and the Newcastle-Ottawa Scale for case controlled studies.The trials were analyzed by Stata12.0.Results A total of 2184 patients from 1 randomized controlled trial (RCT) and 14 case-control studies were included.These patients were divided into two groups based on the treatment method.469 patients were included into the hepatic resection only group and 1087 patients were into the postoperative TACE group.The results showed that postoperative TACE improved the 1-year survival for hepatocellular carcinoma.Subgroup analyses were conducted on the risk factor group (tumor diameter greater than 5cm;multiple nodules and blood vessel invasion) and the no risk factor group.Postoperative TACE played an important role in the risk factor group (subgroup analysis for the no risk factor groupRR =1.10,95％ CI0.97,1.25,P ＞0.05;subgroup analysis for the risk factor groupRR =1.16,95％ CI1.02,1.32,P ＜ 0.05).Postoperative TACE significantly improved the 3 year survival rate in the postoperative TACE group (RR =1.33,95％ CI1.15,1.53,P ＜0.05),but the five-year survival rate showed no significant difference between the two groups (RR=1.21,95％CI0.95,1.15,P＞0.05).Conclusions Postoperative TACE prolonged the survival rate of patients with hepatocellular carcinoma,especially those who had the following risk factorstumor diameter greater than 5 cm;multiple nodules;blood vessel invasion.Postoperative TACE can be recommended as a routine treatment.