Asian Pacific Journal of Cancer Prevention

  • 제16권13호
  • /
  • Pages.5541-5547
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  • 2015
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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Systematic Review of Single Large and/or Multinodular Hepatocellular Carcinoma: Surgical Resection Improves Survival

  • Yang, Xiang-Di (Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Pan, Ling-Hui (Anesthesia Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Wang, Lin (Hepatobiliary Surgery Department, The Second Affiliated Hospital of Kunming Medical University) ;
  • Ke, Yang (Hepatobiliary Surgery Department, The Second Affiliated Hospital of Kunming Medical University) ;
  • Cao, Ji (Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Yang, Chun (Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Zhong, Jian-Hong (Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Luo, Wang (Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Guo, Jiao (Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University) ;
  • Li, Le-Qun (Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University)
  • 발행 : 2015.08.03
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Background: The role of surgical resection for patients with single large (${\geq}5cm$) and/or multinodular (${\geq}2$) hepatocellular carcinoma (HCC) is still controversial. This systematic review was performed to evaluate the safety and efficacy of resection for patients with single large and/or multinodular HCC. Materials and Methods: Databases (the PubMed, Web of Science, Embase, and Cochrane databases) were systematically searched to identify relevant studies exploring the safety and efficacy of resection for single large and/or multinodular HCC, published between January 2000 and December 2014. Perioperative morbidity and mortality, overall survival, and disease-free survival of the resection group were calculated. In addition, these outcome variables were also calculated for the control group in the included studies. Results: One randomized controlled trial and 42 nonrandomized studies involving 9,580 patients were eligible for analysis. Eight (1,594 patients) of the 43 studies also reported the outcomes of transarterial chemoembolization (TACE). Although 51.4% of patients featured cirrhosis, 90.7% of them demonstrated Child-Pugh A liver function in the resection group. The median rates of morbidity (24.5%) and mortality (2.5%) after resection were significantly higher than that of TACE (11.0%, P<0.001; 1.9%, P<0.001). However, patients who underwent resection had significantly higher median one-, three-, and five-year overall survival (76.1%, 51.7%, and 37.4%) than those who underwent TACE (68.3%, 31.5%, and 17.5%, all P<0.001). The median 1-, 3-, and 5-year DFS rates after resection were 58.3%, 34.6%, and 24.0%, respectively. Conclusions: Although tumor recurrence after resection for patients with single large and/ or multinodular HCC continues to be a major problem, resection should be considered as a strategy to achieve long-term survival.

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참고문헌

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