Survival After Anatomic Resection Versus Nonanatomic Resection for Hepatocellular Carcinoma: A Meta-Analysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Jinggui Chen Kai Huang Jianghong Wu Huiyan Zhu Yingqiang Shi Yanong Wang Guangfa Zhao
- چاپ و سال / کشور: 2010
Description
Background and Objectives To compare the effect on survival of anatomic resection (AR) versus nonanatomic resection (NAR) in patients with hepatocellular carcinoma (HCC) from all published comparative studies in the literature. Methods Databases, including Pubmed, Embase, the Cochrane Library, Ovid, and Web of Science, were searched to identify studies comparing AR with NAR for HCC. In this meta-analysis, primary end points were the overall survival and disease-free survival; the secondary end point was local recurrence rate. The meta-analysis was performed by use of RevMan 4.2. Results Nine comparative studies comprising 1,503 patients (833 AR and 670 NAR) were identified. In the combined results, disease-free survival was significantly higher in the AR group than in the NAR group (OR 1.78, 95% CI 1.22–2.59, P = 0.003; heterogeneity P = 0.08). Overall survival (OR 1.31, 95% CI 0.92–1.85, P = 0.13; heterogeneity P = 0.04) did not suggest any significant difference between AR and NAR. No statistically significant difference was found for local recurrence rate between the two resection methods (OR 0.55, 95% CI 0.25–1.23, P = 0.15; heterogeneity P = 0.010). Conclusions Anatomic resection is associated with better disease-free survival than nonanatomic resection. Because heterogeneity was detected, caution is needed in interpretation of the results. Better designed, adequately powered studies are required to address this issue.
Dig Dis Sci (2011) 56:1626–1633 DOI 10.1007/s10620-010-1482-0 Received: 17 August 2010 / Accepted: 26 October 2010 / Published online: 17 November 2010
