肝移植术前经导管肝动脉栓塞化疗对肝细胞癌患者疗效的系统评价
Systematic review of the efficacy of preoperative transarterial chemoembolization for patients with hepatocelhlar carcinoma treated with liver transplantation
王洪良 1黄晨 1黄良飞 1侯善升 1刘飞 1乔鹏飞 1刘越 1贾婷婷 1孙煦勇2
作者信息
- 1. 解放军联勤保障部队第九二三医院器官移植科,南宁 530000
- 2. 广西医科大学第二附属医院移植医学中心,南宁 530000
- 折叠
摘要
目的 评价肝移植术前经导管肝动脉栓塞化疗(TACE)对肝细胞癌患者的疗效.方法 计算机检索PubMed、EMbase、Cochrane数据库、中国知网、万方数据库1990年1月1日至2023年10月31日比较肝细胞癌患者肝移植术前是否行TACE的病例对照研究.提取信息包括:研究者、发表年份、病例数、年龄、性别、干预措施、结局指标等.采用Revman 5.4软件进行统计分析,采用比值比(OR)和95％可信区间(CI)表示统计效应量.结果 共纳入15篇研究,共1 172例患者,其中男性1 000例,女性172例.依据术前是否行TACE分为两组:TACE组(n=654)和非TACE组(n=518).荟萃分析结果显示,TACE组患者的 1年生存率(OR=2.12,95％CI:1.30～3.46)和5年生存率(OR=1.46,95％CI:1.07～1.99)均优于非TACE组,差异有统计学意义(均P＜0.05);TACE组患者的1年无瘤生存率(OR=1.80,95％CI:1.10～2.95)和 5 年无瘤生存率(OR=1.48,95％CI:1.03～2.14)均优于非TACE组,差异有统计学意义(均P＜0.05).结论 肝细胞癌患者在肝移植术前行TACE相对于直接肝移植患者,在术后生存率及无瘤生存率上有优势.但考虑到器官移植为急诊手术的特殊性,在有合适供肝的情况下仍需及时行肝移植.
Abstract
Objective To evaluate the efficacy of preoperative transarterial chemoembolization(TACE)for patients with hepatocellular carcinoma(HCC)treated with liver transplantation.Methods Information from 1 January 1990 to 31 October 2023 was retrieved from PubMed,EMbase,Cochrane library,CNKI,WanFang database.Collected publications were all about case-control study of preoperative TACE or not to HCC.The extracted information included:investigator,year of publication,number of cases,age,gender,intervention measures,outcome indicators,etc.Statistical analysis was performed using Revman 5.4,and odds ratio(OR)and 95％confidence interval(CI)were used to represent the statistical effect size.Results A total of 15 articles including 1 172 patients were enrolled,of these,1 000 were males and 172 were females.They were divided into two groups according to whether preoperative TACE was per-formed,TACE group(n=654),non-TACE group(n=518).The results of the meta-analysis showed that the 1-year(OR=2.12,95％CI:1.30-3.46)and 5-year(OR=1.46,95％CI:1.07-1.99)survival rates in the TACE group were better than those in the non-TACE group,and the difference was statistically significant(all P＜0.05).On the disease-free survival,1-year(OR=1.80,95％CI:1.10-2.95)and 5-year(OR=1.48,95％CI:1.03-2.14)in TACE group were also better than non-TACE group(all P＜0.05).Conclusions The efficacy of preoperative TACE is superior to that of direct liver transplantation in the treatment of hepatocellular carcinoma,including postoperative survival rate and tumor-free survival rate.However,considering the particularity of organ transplantation as an emergency operation,it is still necessa-ry to perform liver transplantation in time when there is a suitable liver donor.
关键词
癌,肝细胞/肝移植/肝动脉化疗栓塞/系统评价Key words
Carcinoma,hepatocellular/Liver transplantation/Transarterial chemoemboliza-tion/Systematic review引用本文复制引用
基金项目
广西科学研究与技术开发计划(桂科攻14124003-8)
广西卫生健康委员会自筹课题(Z20180575)
广西卫生健康委员会自筹课题(Z-A20231058)
出版年
2024
NETL
NSTL
万方数据