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辅助经动脉化疗栓塞改善肝细胞癌合并微血管侵犯患者的生存结局:一项系统性回顾和荟萃分析-ag捕鱼平台

文字: 2019-9-23    浏览次数:353    

 

backgroundthe benefits of adjuvant transarterial chemoembolization (tace) in hepatocellular carcinoma (hcc) patients with microvascular invasion (mvi) remain controversial. we compared the efficacy and safety of adjuvant tace and hepatic resection (hr) alone for hcc patients with mvi.

背景:有关肝细胞癌(hcc)合并微血管侵犯(mvi)患者辅助经动脉化疗栓塞(tace)的获益仍存在争议。我们对辅助tace及单独行肝切除(hr)治疗hcc合并 mvi患者的疗效和安全性进行了比较。

 

methodsthe pubmed, embase, cochrane library, vip, wan fang, and sino med databases were systematically searched to compare adjuvant tace and hr alone for the treatment of hcc with mvi from inception to january 1, 2019. the study outcomes, including overall survival (os) and disease-free survival (dfs), were extracted independently by two authors.

方法:系统检索至201911日的pubmedembasecochrane图书馆、维普、万方及sino med数据库,对比辅助tace和单独行hr治疗hcc合并mvi的临床结局。研究结果包括总生存(os)和无病生存期(dfs),数据由两位作者独立提取。

 

results12 trials involving 2190 patients were evaluated. a meta-analysis of 11 studies suggested that the 1-, 3-, and 5-year overall survival (os) rates (or=0.33, p<0.001; or=0.49, p<0.001; and or=0.59, p<0.01; respectively), favored adjuvant tace over hr alone. 11 studies were included in the meta-analysis of dfs, and adjuvant tace showed better 1-, 3-, and 5-dfs (or=0.45, p<0.001; or=0.50, p<0.001; and or=0.58, p<0.001; respectively) compared to hr alone. subgroup analysis demonstrated that adjuvant tace could benefit hcc patients with mvi with tumor diameter >5cm or multinodular tumors.

结果:共评估了12项试验,涉及2190例患者。对11项研究的荟萃分析显示,与单独行hr相比,135年总生存率结果更倾向于使用辅助tace治疗(or = 0.33, p < 0.001;or = 0.49, p < 0.001;or = 0.59, p < 0.01)。11项研究的荟萃分析dfs结果显示,与单独行hr相比,辅助tace 135年的dfs更高(or=0.45, p<0.001; or=0.50, p<0.001; or=0.58, p<0.001)。亚组分析显示,辅助tace治疗对肿瘤直径> 5cm或有多结节肿瘤的hcc合并mvi患者有利。

 

conclusionadjuvant tace may improve os and dfs for hcc patients with mvi compared to hr alone and should be recommended for selected hcc patients with mvi. however, these results need to be validated through further high-quality clinical studies.

结论:与单独行肝切除(hr)相比,辅助tace可改善hcc合并微血管侵犯(mvi)患者的osdfs,对于特定的hcc合并mvi患者应予以推荐。然而,这些结果还有待通过进一步的高质量临床研究去验证。