A Meta-analysis of TAE/TACE Versus Emergency Surgery in the Treatment of Ruptured HCC
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REVIEW
INTERVENTIONAL ONCOLOGY
A Meta-analysis of TAE/TACE Versus Emergency Surgery in the Treatment of Ruptured HCC Xinjian Xu1,2 • Changsheng Chen3 • Qiang Liu1 • Xiangzhong Huang2
Received: 29 December 2019 / Accepted: 2 May 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Objectives To evaluate the efficacy and safety of TAE/ TACE versus emergency surgery (ES) for spontaneous rupture of HCC (rHCC). Methods Eight databases (Web of Science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, Wanfang, CNKI and VIP) were searched to obtain all related literature from the inception dates to October 2019. Subgroup Xin Jian Xu and Changsheng Chen are contributed equally to this work and should be considered Co-first authors. Xiang Zhong Huang and Qiang Liu are contributed equally to this work and should be considered Co-corresponding author.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00270-020-02514-5) contains supplementary material, which is available to authorized users. & Qiang Liu [email protected] & Xiangzhong Huang [email protected] Xinjian Xu [email protected]
analyses based on the kind of study design and kind of embolization were conducted. Results Twenty-one studies comparing TAE/TACE with ES were eligible. A total of 974 rHCC participants (485 participants treated with TACE/TAE and 489 participants treated with ES) were included in the present meta-analysis. TAE/TACE group was associated with lower risk of complications (OR = 0.36; 95% CI, 0.22–0.57; P \ 0.0001) and in-hospital mortality (OR = 0.52; 95% CI, 0.29–0.94; P = 0.03) compared with ES group. In addition, no significant difference in successful hemostasis (OR = 1.67; 95% CI, 0.85–3.28; P = 0.13) and 1-year survival (OR = 1.08; 95% CI, 0.79–1.48; P = 0.64) between TAE/TACE and ES groups was demonstrated. Conclusions TAE/TACE had comparable outcomes to ES in terms of successful hemostasis and 1-year survival. Meanwhile, TAE/TACE was significantly superior to ES in terms of complications and in-hospital mortality. Therefore, TAE/TACE may be recommended as a preferable treatment for rHCC. Keywords Rupture HCC TAE TACE Emergency surgery
Changsheng Chen [email protected] 1
2
3
Department of Radiology, Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China Department of Interventional Radiology, Jiang yin people’s hospital, No. 3, Yingrui Road, Jiangyin 214400, Jiangsu, China Department of Human Resources, Department of Radiology, Jiang yin people’s hospital, No. 3, Yingrui Road, Jiangyin 214400, Jiangsu, China
Introduction As a life-threatening complication of HCC, spontaneous rupture of HCC (rHCC) occurs in about 3–15% of HCC patients and has a very poor prognosis [1–5]. Emergency surgery (ES) and TAE are two feasible treatments for the
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X. Xu et al.: A Meta-analysis of TAE/TACE Versus Emergency
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