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Characteristics and outcomes of hepatocellular carcinoma patients with macrovascular invasion following surgical resection: a meta-analysis of 40 studies and 8,218 patients

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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 848-860,I0001-I0015页

作者： Daniel Q.Huang Andrew Tran eunice xtan Sanjna N.Nerurkar Readon Teh Margaret L.P.Teng Ee Jin Yeo Biyao Zou Connie Wong Carlos O.Esquivel CAndrew Bonham Mindie H.Nguyen Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Duke University DurhamNCUSA Adelaide Medical School The University of AdelaideAdelaideAustralia Division of Gastroenterology and Hepatology Department of MedicineStanford University Medical CenterPalo AltoCAUSA Department of Epidemiology and Population Health Stanford University School of MedicineStanfordCAUSA Lane Medical Library Stanford University School of MedicineStanfordCAUSA Division of Abdominal Transplantation Department of SurgeryStanford University School of MedicineStanfordCAUSA

Background:Guidelines recommend that hepatocellular carcinoma(HCC)patients with portal vein tumor thrombosis(PVTT)and/or hepatic vein tumor thrombosis(HVTT)should undergo systemic ***,recent data suggest that surgical resection may be beneficial in selected cases,but outcomes are *** aimed to estimate pooled overall survival(OS),recurrence free survival(RFS)and complication rates in HCC patients with macrovascular invasion(MVI)following surgical ***:In this systematic review and meta-analysis,two investigators independently searched PubMed,Embase,and Cochrane databases from inception to Nov 10,2020,without language restrictions,for studies reporting outcomes of adult HCC patients with MVI who underwent liver resection with curative ***:We screened 8,598 articles and included 40 studies involving 8,218 *** all patients with MVI,the pooled median OS was 14.39 months[95%confidence interval(CI):10.99-18.84],1-year OS was 54.47%(95%CI:46.12-62.58%)and 3-year OS was 23.20%(95%CI:16.61-31.42%).Overall,1-and 3-year RFS were 27.70%(95%CI:21.00-35.57%)and 10.06%(95%CI:6.62-15.01%),*** patients with PVTT,median OS was 20.41 months in those with segmental/2nd order involvement compared to 12.91 months if 1st order branch was involved and 6.41 months if the main trunk was *** pooled rate of major complications was 6.17%(95%CI:3.53-10.56%).Conclusions:Overall median survival was 14.39 months for HCC patients with MVI following *** survival was higher in PVTT with segmental/2nd order involvement at 20.41 versus 6.41 months if the main trunk was involved.

关键词： Hepatocellular carcinoma(HCC) resection portal vein macrovascular invasion(MVI) recurrence

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