A Meta-analysis Of Postoperative Arterial Chemoembolization Acting To Avoid Recurrence And Improve Survival Rate

Objective : Evaluate arterial chemoembolization in preventing recurrence and improving patients's urvival after curative resection for hepatocellular carcinoma by using a Meta-analysis.Methods: Search only for Chinese and English related studies before Feb 28th, 2009 in ProQuest, PubMed, EMCC, CNKI, CBM, Weipu and Wanfang data. Retrieve all prospective randomized, controlled trials related to arterial chemoembolization after primary liver cancer resection, and then implement quality evaluation to them with modified Jadad Scale. Access the heterogeneity of the chosen ones with chi-square, applying RevMan5.0 and set testing standard(α) at 0.05. If it shows no statistic differences in heterogeneity, fixed effect mode of Meta-analysis will be applied, or merging study in random effect mode will be adopted. Analyze sensitivity to random effect and draw funnel plots to check the bias.Results: 9 documents are picked out and come into Meta-analysis, involved 561 patients with 298 composing one group taking arterial chemoembolization and 263 making the controlled group. Compared with curing liver cancer only by operation, the OR(95%CI) of the recurrence one, two or three years after the operation are 0.25( 0.16,0.40),0.26( 0.13,0.50),0.34( 0.20,0.56), which all have statistic significance, and this reflects that postoperative arterial chemoembolization can reduce recurrence rate after operation. Compared with curing liver cancer only by operation, the OR(95%CI) of the total survival rate one, two or three years after the operation are 3.91(2.45,6.26), 3.86( 2.23,6.65), 3.07(1.96,4.80) , which also have statistic significance, and show that postoperative arterial chemoembolization can increase the total survival rate after operation.Conclusions: This research proves that postoperative arterial chemoembolization can reduce recurrence rate after operation and increase the total survival rate after operation. However, because the statistic quality of most of chosen research reports is comparably low and the quantity is very few, more and higher randomized, controlled experiments are demanded to further evaluate and prove the effect of postoperative arterial chemoembolization.