Detailed Abstract
[Poster - Liver Disease/Surgery]
[P020] Is surgical resection justified for hepatocellular carcinoma with portal vein tumor thrombus? (a systematic review and meta-analysis)
Liang LEI1, Xin-Fei XU1,2, Jiong-Jie YU1,2, Ju-Dong LI1,2, Zhen-Li LI1, Jun HAN1, Han ZHANG1, Hao XING1, Han WU1, Ming-Da WANG1, Chao LI1, Zheng WANG1,2, Feng SHEN1, Meng-Chao WU1, Tian YANG1
1Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital of Second Military Medical University, China
2Department of Clinical Medicine, Second Military Medical University, China, China
Introduction : The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is very poor. According to the BCLC treatment recommendations, sorafenib or other palliative treatment (PT) is recommended as the first-line therapy when it happens. In real world, however, a significant number of selected patients with HCC and PVTT suffered from surgical resection (SR).
Methods : PubMed, Embase, Medline and Cochrane library were searched for studies comparing SR with PT (including TACE, sorafenib, etc.) for HCC with PVTT, which were published before September 2017.
Results : 4,810 patients from 7 studies were enrolled in this meta-analysis, which divided into the SR group (n = 2,344) and the PT group (n = 2476). When compared with the PT group, the pooled hazard ratio (HR) for the 1, 3 and 5-year OS rates of the SR group were 0.56 (95% CI 0.52–0.60, P = 0.03), 0.56 (95% CI 0.53–0.59, P < 0.001) and 0.55 (95% CI 0.54–0.57, P < 0.001). For subgroup analysis, when compared with the mere TACE group, the pooled HR for the 1, 3 and 5-year OS rates of the SR group were 0.54 (95% CI 0.43–0.67, P = 0.81), 0.75 (95% CI 0.65–0.87, P = 0.25) and 0.76 (95% CI 0.67–0.88, P = 0.25).
Conclusions : This meta-analysis demonstrated SR had better OS than TACE or other palliative therapy for HCC with PVTT. SR may be suitable as the first-line treatment for selected patients with resectable HCC and removable PVTT.
Methods : PubMed, Embase, Medline and Cochrane library were searched for studies comparing SR with PT (including TACE, sorafenib, etc.) for HCC with PVTT, which were published before September 2017.
Results : 4,810 patients from 7 studies were enrolled in this meta-analysis, which divided into the SR group (n = 2,344) and the PT group (n = 2476). When compared with the PT group, the pooled hazard ratio (HR) for the 1, 3 and 5-year OS rates of the SR group were 0.56 (95% CI 0.52–0.60, P = 0.03), 0.56 (95% CI 0.53–0.59, P < 0.001) and 0.55 (95% CI 0.54–0.57, P < 0.001). For subgroup analysis, when compared with the mere TACE group, the pooled HR for the 1, 3 and 5-year OS rates of the SR group were 0.54 (95% CI 0.43–0.67, P = 0.81), 0.75 (95% CI 0.65–0.87, P = 0.25) and 0.76 (95% CI 0.67–0.88, P = 0.25).
Conclusions : This meta-analysis demonstrated SR had better OS than TACE or other palliative therapy for HCC with PVTT. SR may be suitable as the first-line treatment for selected patients with resectable HCC and removable PVTT.
SESSION
Poster
Poster / Exhibition Hall and Lobby(2F) 1/1/1970 9:00 AM - 9:00 AM