Effects of Combined TACE and PVC for Primary Hepatocellular Carcinoma: Meta-Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SHANGHao , LUHong-wei , ZHANGYa-fei , JIHong ,  LIYi-ming

Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China;

Corresponding?author：

LIYi-ming, Email: liyimingdoc@163.com

Keywords：

Hepatocellular carcinoma; Transarterial chemoembolization; Portal venous chemotherapy; Survival rate; Meta-analysis

DOI：

10.7507/1007-9424.20150310

Video：

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Objective To evaluate the effects of combined TACE and PVC regarding the survival and diseasefree survival rate in hepatocellular carcinoma (HCC) patients. Methods The relevant articles were searchd by a database search of PubMed, EMBASE, Cochrane Library (CENTRAL) Databases, Web of Science, Sciencedirect, National Institute of Health Clinical Trials Database, CNKI, WANFANG Database, and VIP Database. The analysis of the data was performed using Revman 5.1 Software. Results By searching and selecting, a total of ten articles met the inclusion criteria, of which 6 were in the postoperative group, and 4 were in the no-operative group. There were no statistical significance of heterogeneity in each group through subgroup analyzed. The pooled OR showed that combined TACE and PVC could significantly increase the 1-, 2-, and/or 3-year survival and disease-free survival rates compared with TACE alone for HCC patients. The pooled OR and 95% CI of the 1-, 2-and/or 3-year survival and disease-free survival rate, respectively, were as follows:In operative group, 1-year disease-free survival rate 2.09, 1.21-3.61; 3-year disease-free survival rate 3.62, 1.88-6.97; 1-year survival rate 2.25, 1.30-3.87; 3-year survival rate 1.96, 1.20-3.21. In no-perative group:1-year survival rate 3.90, 2.33-6.54; 2-year survival rate 5.30, 1.87-15.06. Conlusions Compared with TACE alone, postoperative adjuvant combined TACE and PVC can significantly increase the 1-, and 3-year survival and disease-free survival rates. For no-perative group, adjuvant combined TACE and PVC can significantly increase the 1-, and 2-year survival rates. Based on the limitations of this meta-analysis (this article is included in the high quality literature less), clinicians should be cautious by using our findings.

Citation： SHANGHao, LUHong-wei, ZHANGYa-fei, JIHong, LIYi-ming. Effects of Combined TACE and PVC for Primary Hepatocellular Carcinoma: Meta-Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1192-1199. doi: 10.7507/1007-9424.20150310 Copy

1.	Parkin DM, Bray F, Ferlay J, et al. Estimating the world cancer burden:Globocan 2000. Int J Cancer, 2001, 94(2):153-156.
2.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
3.	Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2917.
4.	中華人民共和國衛生部.原發性肝癌診療規范(2011版).臨床肝膽病雜志, 2011, 27(11):1141-1159.
5.	Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Clinicopathologic features and results of surgical treatment. Ann Surg, 1990, 211(3):277-287.
6.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Available from http://handbook.cochrane.org/.
7.	Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in metaanalysis. Available:www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
8.	Li Q, Wang J, Sun Y, et al. Efficacy of postoperative transarterial chemoembolization and portal vein chemotherapy for patients with hepatocellular carcinoma complicated by portal vein tumor thrombosis——a randomized study. World J Surg, 2006, 30(11):2004-2011, discussion 2012-2013.
9.	莊建彬, 王毅軍, 杜智, 等.肝動脈插管化療栓塞聯合門靜脈化療對肝細胞癌病人術后生存期的影響.中華肝膽外科雜志, 2010, 16(8):579-581.
10.	張煥虎, 孫勝波, 韓傳吉, 等.雙途徑化療對合并門靜脈癌栓肝癌患者預后的影響(3年隨訪報告).中華流行病學雜志, 2012, 33(11):1181-1183.
11.	鄭盛, 唐映梅, 尤麗英, 等.雙途徑化療治療肝癌并發門靜脈癌栓患者對預后的影響.實用肝臟病雜志, 2013, 16(4):351-353.
12.	童穎, 楊甲梅, 徐峰, 等.原發性肝癌伴門靜脈癌栓行術后肝動脈化療栓塞聯合門靜脈化療的療效觀察.中華肝膽外科雜志, 2008, 14(12):851-853.
13.	張耀明, 周臻濤, 羅宇峰, 等.原發性肝癌合并門靜脈癌栓術后雙路介入治療的效果評價.中國腫瘤外科雜志, 2013, 5(5):283-285.
14.	崔林, 周向榮, 朱扣林, 等.肝動脈化療栓塞聯合門靜脈持續灌注化療治療原發性肝癌的臨床觀察.腫瘤基礎與臨床, 2009, 22(5):409-410.
15.	朱偉, 李小靜.介入治療原發性肝癌合并門靜脈癌栓的療效分析.臨床合理用藥, 2013, 6(1):10-11.
16.	皮儒先, 陳平, 伍強, 等.介入治療原發性肝細胞癌合并門靜脈癌栓66例的臨床分析.胃腸病學和肝病學雜志, 2014, 23(11):1319-1321.
17.	童穎, 楊甲梅, 吳孟超, 等.原發性肝癌伴門靜脈癌栓的TACE+ PVC聯合治療.上海:第二軍醫大學, 2004.
18.	GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specifi c all-cause and causespecific mortality for 240 causes of death, 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, 385(9963):117-171.
19.	Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4):378-390.
20.	Cheng X, Sun P, Hu QG, et al. Transarterial (chemo) embolization for curative resection of hepatocellular carcinoma:a systematic review and meta-analyses. J Cancer Res Clin Oncol, 2014 Jul, 140(7):1159-1170.
21.	Wallace S, Kan Z, Li C, et al. Hepatic chemoembolization:Clinical and experimental Correlation. Acta Gastroenterol Belg, 2000, 63(2):169-173.
22.	Yamaguchi A, Taniguchi H, Kunishima S, et al. Correlation between angiographically assessed vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma. Cancer, 2000, 89(6):1236-1244.
23.	Hayashi M, Matsui O, Ueda K, et al.Progression to hypervascular hepatocellular carcinoma:correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology, 2002, 225(1):143-149.
24.	Verslype C, Rosmorduc O, Rougier P, et al. Hepatocellular carcinoma:ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2012, 23 Suppl 7:vii41-vii48.
25.	Momosaki S, Nakashima Y, Kojiro M, et al. HBsAg-negative hepatitis B virus infections in hepatitis C virus-associated hepatocellular carcinoma. J Viral Hepat, 2005, 12(3):325-329.
26.	李錦清, 張昌卿, 張亞奇, 等.肝癌切除術后輔助肝動脈栓塞化療的價值.中國普外基礎與臨床雜志, 2006, 13(2):135-137.
27.	Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma:toward zero hospital deaths. Ann Surg, 1999, 229(3):322-330.
28.	Chen XP, Huang ZY. Surgical treatment of hepatocellular carcinoma in China:surgical techniques, indications, and outcomes. Langenbecks Arch Surg, 2005, 390(3):259-265.
29.	Morise Z, Kawabe N, Tomishige H, et al. Recent advances in the surgical treatment of hepatocellular carcinoma. World J Gastroenterol, 2014, 20(39):14381-14392.
30.	Li JQ, Zhang YQ, Zhang WZ, et al. Randomized study of chemoem bolization as an adjuvant therapy for primary liver carcinoma after hepatectomy. J Cancer Res Clin Oncol, 1995, 121(6):364-366.
31.	Cho JY, Paik YH, Park HC, et al. The feasibility of combined transcatheter arterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma. Liver International, 2014, 34(5):795-801.
32.	Yong Li, Zheng YB, Zhao W, et al. Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma. Med Oncol, 2013, 30(4):730.
33.	Watanabe Y, Nakaba H, Taniguchi E, et al. Successful treatment of metastatic hepatocellular carcinoma with sorafenib combined with transcatheter arterial chemoembolization/hepatic arterial infusion chemotherapy. Gan To Kagaku Ryoho, 2014, 41(12):2110-2112.
34.	Hu H, Duan Z, Long X, et al. Comparison of treatment safety and patient survival in elderly versus nonelderly patients with advanced hepatocellular carcinoma receiving sorafenib combined with transarterial chemoembolization:a propensity score matching study. PLoS One, 2015, 10(2):e0117168.
35.	Zhang L, Hu P, Chen X, et al. Transarterial chemoembolization (TACE) plus sorafenib versus TACE for intermediate or advanced stage hepatocellular carcinoma:a meta-analysis. PLoS One, 2014, 9(6):e100305.
36.	Fu QH, Zhang Q, Bai XL, et al. Sorafenib enhances effects of transarterial chemoembolization for hepatocellular carcinoma:a systematic review and meta-analysis. J Cancer Res Clin Oncol, 2014, 140(8):1429-1440.
37.	Liu L, Chen H, Wang M, et al. Combination therapy of sorafenib and TACE for unresectable HCC:a systematic review and metaanalysis. PLoS One, 2014, 9(3):e91124.

1. Parkin DM, Bray F, Ferlay J, et al. Estimating the world cancer burden:Globocan 2000. Int J Cancer, 2001, 94(2):153-156.
2. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2):69-90.
3. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008. Int J Cancer, 2010, 127(12):2893-2917.
4. 中華人民共和國衛生部.原發性肝癌診療規范(2011版).臨床肝膽病雜志, 2011, 27(11):1141-1159.
5. Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Clinicopathologic features and results of surgical treatment. Ann Surg, 1990, 211(3):277-287.
6. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Available from http://handbook.cochrane.org/.
7. Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in metaanalysis. Available:www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
8. Li Q, Wang J, Sun Y, et al. Efficacy of postoperative transarterial chemoembolization and portal vein chemotherapy for patients with hepatocellular carcinoma complicated by portal vein tumor thrombosis——a randomized study. World J Surg, 2006, 30(11):2004-2011, discussion 2012-2013.
9. 莊建彬, 王毅軍, 杜智, 等.肝動脈插管化療栓塞聯合門靜脈化療對肝細胞癌病人術后生存期的影響.中華肝膽外科雜志, 2010, 16(8):579-581.
10. 張煥虎, 孫勝波, 韓傳吉, 等.雙途徑化療對合并門靜脈癌栓肝癌患者預后的影響(3年隨訪報告).中華流行病學雜志, 2012, 33(11):1181-1183.
11. 鄭盛, 唐映梅, 尤麗英, 等.雙途徑化療治療肝癌并發門靜脈癌栓患者對預后的影響.實用肝臟病雜志, 2013, 16(4):351-353.
12. 童穎, 楊甲梅, 徐峰, 等.原發性肝癌伴門靜脈癌栓行術后肝動脈化療栓塞聯合門靜脈化療的療效觀察.中華肝膽外科雜志, 2008, 14(12):851-853.
13. 張耀明, 周臻濤, 羅宇峰, 等.原發性肝癌合并門靜脈癌栓術后雙路介入治療的效果評價.中國腫瘤外科雜志, 2013, 5(5):283-285.
14. 崔林, 周向榮, 朱扣林, 等.肝動脈化療栓塞聯合門靜脈持續灌注化療治療原發性肝癌的臨床觀察.腫瘤基礎與臨床, 2009, 22(5):409-410.
15. 朱偉, 李小靜.介入治療原發性肝癌合并門靜脈癌栓的療效分析.臨床合理用藥, 2013, 6(1):10-11.
16. 皮儒先, 陳平, 伍強, 等.介入治療原發性肝細胞癌合并門靜脈癌栓66例的臨床分析.胃腸病學和肝病學雜志, 2014, 23(11):1319-1321.
17. 童穎, 楊甲梅, 吳孟超, 等.原發性肝癌伴門靜脈癌栓的TACE+ PVC聯合治療.上海:第二軍醫大學, 2004.
18. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specifi c all-cause and causespecific mortality for 240 causes of death, 1990-2013:a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 2015, 385(9963):117-171.
19. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med, 2008, 359(4):378-390.
20. Cheng X, Sun P, Hu QG, et al. Transarterial (chemo) embolization for curative resection of hepatocellular carcinoma:a systematic review and meta-analyses. J Cancer Res Clin Oncol, 2014 Jul, 140(7):1159-1170.
21. Wallace S, Kan Z, Li C, et al. Hepatic chemoembolization:Clinical and experimental Correlation. Acta Gastroenterol Belg, 2000, 63(2):169-173.
22. Yamaguchi A, Taniguchi H, Kunishima S, et al. Correlation between angiographically assessed vascularity and blood flow in hepatic metastases in patients with colorectal carcinoma. Cancer, 2000, 89(6):1236-1244.
23. Hayashi M, Matsui O, Ueda K, et al.Progression to hypervascular hepatocellular carcinoma:correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material. Radiology, 2002, 225(1):143-149.
24. Verslype C, Rosmorduc O, Rougier P, et al. Hepatocellular carcinoma:ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2012, 23 Suppl 7:vii41-vii48.
25. Momosaki S, Nakashima Y, Kojiro M, et al. HBsAg-negative hepatitis B virus infections in hepatitis C virus-associated hepatocellular carcinoma. J Viral Hepat, 2005, 12(3):325-329.
26. 李錦清, 張昌卿, 張亞奇, 等.肝癌切除術后輔助肝動脈栓塞化療的價值.中國普外基礎與臨床雜志, 2006, 13(2):135-137.
27. Fan ST, Lo CM, Liu CL, et al. Hepatectomy for hepatocellular carcinoma:toward zero hospital deaths. Ann Surg, 1999, 229(3):322-330.
28. Chen XP, Huang ZY. Surgical treatment of hepatocellular carcinoma in China:surgical techniques, indications, and outcomes. Langenbecks Arch Surg, 2005, 390(3):259-265.
29. Morise Z, Kawabe N, Tomishige H, et al. Recent advances in the surgical treatment of hepatocellular carcinoma. World J Gastroenterol, 2014, 20(39):14381-14392.
30. Li JQ, Zhang YQ, Zhang WZ, et al. Randomized study of chemoem bolization as an adjuvant therapy for primary liver carcinoma after hepatectomy. J Cancer Res Clin Oncol, 1995, 121(6):364-366.
31. Cho JY, Paik YH, Park HC, et al. The feasibility of combined transcatheter arterial chemoembolization and radiotherapy for advanced hepatocellular carcinoma. Liver International, 2014, 34(5):795-801.
32. Yong Li, Zheng YB, Zhao W, et al. Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma. Med Oncol, 2013, 30(4):730.
33. Watanabe Y, Nakaba H, Taniguchi E, et al. Successful treatment of metastatic hepatocellular carcinoma with sorafenib combined with transcatheter arterial chemoembolization/hepatic arterial infusion chemotherapy. Gan To Kagaku Ryoho, 2014, 41(12):2110-2112.
34. Hu H, Duan Z, Long X, et al. Comparison of treatment safety and patient survival in elderly versus nonelderly patients with advanced hepatocellular carcinoma receiving sorafenib combined with transarterial chemoembolization:a propensity score matching study. PLoS One, 2015, 10(2):e0117168.
35. Zhang L, Hu P, Chen X, et al. Transarterial chemoembolization (TACE) plus sorafenib versus TACE for intermediate or advanced stage hepatocellular carcinoma:a meta-analysis. PLoS One, 2014, 9(6):e100305.
36. Fu QH, Zhang Q, Bai XL, et al. Sorafenib enhances effects of transarterial chemoembolization for hepatocellular carcinoma:a systematic review and meta-analysis. J Cancer Res Clin Oncol, 2014, 140(8):1429-1440.
37. Liu L, Chen H, Wang M, et al. Combination therapy of sorafenib and TACE for unresectable HCC:a systematic review and metaanalysis. PLoS One, 2014, 9(3):e91124.

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Effects of Combined TACE and PVC for Primary Hepatocellular Carcinoma: Meta-Analysis

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