A Meta-analysis of the clinical efficacy of hepatic arterial chemoembolization combined with second-stage surgical resection and hepatic arterial chemoembolization alone for unresectable intermediate and advanced liver cancer in Chinese population
Objective The aim of this study was to compare the clinical efficacy of hepatic artery chemoembolization com-bined with two-stage surgical resection and simple hepatic arterial chemoembolization in the treatment of unresectable advanced liver cancer in the Chinese population.Methods A clinical controlled study literature was collected in China through computer and manu-al retrieval on the combination of hepatic arterial chemoembolization with two-stage surgery and hepatic arterial chemoembolization a-lone for the treatment of unresectable liver cancer.A Meta-analysis was conducted on 17 experiments that met the inclusion criteria u-sing Revman 5.2 software and applying heterogeneity test analysis.Results Compared with the combination of hepatic artery chemo-embolization and phase Ⅱ surgery,simple hepatic arterial chemoembolization had higher postoperative 1-year,2-year and 3-year risk of death(OR=2.82,2.22 and 3.40,P＜0.05).In addition,under the same conditions of chemoembolization drugs,compared with the combination of hepatic arterial chemoembolization and phase Ⅱ s,simple hepatic arterial chemoembolization had higher postoperative 1-year and 3-year risk of death(OR=6.74,4.64,P＜0.05).Compared with simple hepatic arterial chemoembolization,thehe combi-nation of hepatic arterial chemoembolization and phase Ⅱ surgery had a lower 1-year disease progression risk(OR=0.46),but there was no significant difference(P＞0.05).The disease progression risk continued to decrease 2 years after surgery(OR=0.29,P＜0.05).Conclusion The long-term efficacy of hepatic arterial chemoembolization combined with two-stage surgery in the treatment for unresectable liver cancer is better than that of hepatic arterial chemoembolization alone,whic can effectively improve patients sur-vival and reduce disease progression rate.
Advanced liver cancerUnresectableHepatic artery chemoembolizationSecond-stage surgery
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