Prognosis Of Liver Transplantation And Hepatectomy In Child-Pugh A Primary Hepatic Carcinoma Patients With Milan Criteria: A Meta-analysis

Objective:Choose liver transplantation or liver resection remains controversial for Child-Pugh A primary hepatic carcinoma patients within Milan criteria.This study aims to systematically evaluate the prognostic of liver resection and liver transplantation in Child-Pugh A primary hepatic carcinoma patients within Milan criteria.Methods:Search for all English related studies that explored the prognosis of liver resection and liver transplantation in Child-Pugh A primary hepatic carcinoma patients within Milan criteria via MEDLINE,EMBASE,PubMed,The Cochrane Library(CENTRAL)and Web of Science databases.The retrieval time was from inception to March 2017.The literature according to the inclusion and exclusion criteria,extracted data and assessed methodological quality was screened by two reviewers independently.Then we performed Meta-analysis using Review Manager 5.3 software.Results:10 studies were included with a total of 983 patients(liver resection 593,liver transplantation 390).The meta-analysis indicates that the liver transplantation group has higher 3-year overall survival(OR:0.59,95% CI:0.42-0.83,P=0.002)、5-year overall survival(OR:0.52,95%CI:0.39-0.70,P<0.00001)and 5-year disease-free survival(OR:0.30,95%CI:0.17-0.54,P<0.0001)compared with liver resection group,but there was no significant difference in 1-year overall survival(OR:0.80,95%CI: 0.56-1.15,P=0.23)、 1-year disease-free survival(OR:0.19,95%CI: 0.03-1.15,P=0.07)and 3-year disease-free survival(OR:0.65,95%CI: 0.41-1.02,P=0.06)between the two groups.Conclusion:Compared with liver resection,liver transplantation can better improve the prognosis for Child-Pugh A primary hepatic carcinoma patients within Milan criteria.