Which is the best combination of surgery for hepatocellular carcinoma with hepatic/portal vein thrombosis in China: a network meta-analysis of randomized controlled trials

To assess the efficacy and safety of different perioperative regimens using network meta-analysis for hepatocellular carcinoma (HCC) with hepatic/portal vein thrombosis. The interested modalities included neoadjuvant three-dimensional conformal radiotherapy (3D-CRT), post-operative intensity modulat...

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Bibliographic Details
Published in:	Journal of B.U.ON. : official journal of the Balkan Union of Oncology Vol. 26; no. 3; p. 889
Main Authors:	Wu, Qi-Qiao, Chen, Yi-Xing, Zheng, Ting-Ting, Dai, Meng-Ting, Ye, Ting, Xu, Yu-Hong, Hu, Yong, Du, Shi-Suo, Zeng, Zhao-Chong
Format:	Journal Article
Language:	English
Published:	Cyprus 01-05-2021
Subjects:	Carcinoma, Hepatocellular - complications Carcinoma, Hepatocellular - surgery Carcinoma, Hepatocellular - therapy China Combined Modality Therapy Hepatic Veins Humans Liver Neoplasms - complications Liver Neoplasms - surgery Liver Neoplasms - therapy Network Meta-Analysis Portal Vein Randomized Controlled Trials as Topic Treatment Outcome Venous Thrombosis - complications Venous Thrombosis - therapy China
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Summary:	To assess the efficacy and safety of different perioperative regimens using network meta-analysis for hepatocellular carcinoma (HCC) with hepatic/portal vein thrombosis. The interested modalities included neoadjuvant three-dimensional conformal radiotherapy (3D-CRT), post-operative intensity modulated radiation therapy (IMRT). post-operative transarterial chemoembolization (TACE) and surgery alone. PubMed and Cochrane Library electronic databases were systematically searched for eligible studies published up to November 2020. Data related to treatment efficacy including overall survival (OS), and disease-free survival (DFS) were extracted and compared using a Bayesian approach. Adverse events (AEs) were assessed and compared. Four studies published between 2005 and 2020 involving a total of 422 patients were enrolled in this network meta-analysis. The comparison showed that surgery with IMRT ranked relatively higher in prolonging OS in advanced HCC patients, followed by neoadjuvant 3DCRT and surgery plus TACE. Postoperative IMRT appeared better choice in terms of DFS. The rate of AEs did not significantly differ. Adjuvant IMRT showed more favorable treatment responses compared with other regimens in HCC patients with hepatic/portal vein thrombosis.
ISSN:	2241-6293