Hepatic Resection Improved The Long-Term Survival Of Patient With Large (>5cm) Hepatocellular Carcinoma:a Meta Analysis

Object Hepatic resection has been increasingly performed in patients with large(>5cm) hepatocellular carcinoma who are divided into Barcelona Clinic Liver Cancer (BCLC) stage B, but the current evidence supporting its efficacy remains controversial. The aim of this systematic review was to investigate the long-term survival and safety of hepatic resection compared to Transarterial chemoembolization.Methods We performed a search on PubMed、Medline、CBM、CNKI、 VIP databases for all relevant studies published from 1990.01 prior to 2015.01. After exclusions,6 studies remained for appraisal and data extraction. Rev Man 4.22 software was used to make the meta analysis. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of all the studies.Results A total of 6 studies containing 2005 patients were included. The NOS score of all the studies range from 7 to 9.Meta analyses showed that, compared with the TACE group. Patient undergo hepatic resection have the similar treatment-related liver failure rate、treatment-related complication rate and treatment-related death rate with TACE group.But the 1、3、5year over-all survival and 1、3、5year DFS of hepatic resection is better than TACE.Conclusion Hepatic resection can be performed safely and is associated with long-term survival in a subset of patients with large HCC and did not increase the incidence of treatment-related complications.But the evidence of benefit is currently weak.