| Objective: This study aims to use meta-analysis to analyse the effectof pre-transplantation palliative treatment on survival rate in patients withhepatocellular carcinoma.Background: With the condition of world-wide organ shortage, manypatients have to wait for a long time in the waiting list, which cause tumorprogression and drop-out. In order to reduce drop-out in the waiting list,some transplantation centers adopt palliative treatment to control tumorprogression, but if palliative treatment can improve survival after livertransplantation in patients with hepatocellular carcinoma is stillcontroversial.Methods: The articles about the effect of palliative treatment on livertransplantation in patients with hepatocellular carcinoma are identified withPubmed, Embase. The patients accepted palliative treatment before livertransplantation as study group and non-accepted palliative treatment ascontrol group, Endpoints were1y,3y,5y survival rate after livertransplantation. Also, we take the patients achieving complete response to palliative treatment as CR group and the others as non-CR group tocompare the5y survival rate.Results: Eight retrospective studies including843patients areincluded. There is no benefit of palliative treatment on the1y survival rate［RR=1.02,95%CI（0.94,1.10）, P=0.64］,3y survival rate［RR=1.00,95%CI（0.89,1.13）, P=0.99］,5y survival rate［RR=1.00,95%CI（0.88,1.12）, P=0.96］. Three retrospective studies including315patients areincluded to analyse the effect on post-transplantation survival rate ofcomplete response to palliative treatment. Patients with complete responseto palliative treatment have higher5y survival rate［RR=1.46,95%C（I1.23,1.74）, P<0.0001］.Conclusions: The results of this meta-analysis suggest that there is nobenefit of palliative treatment on the post-transplantation survival rate inpatients with hepatocellular carcinoma, but the patients with completeresponse to palliative treatment have higher post-transplantation survivalrate. |
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