肝细胞癌合并门静脉癌栓的围手术期局部区域辅助治疗的生存益处：一项系统评价与贝叶斯网络荟萃分析。
Survival benefit of perioperative locoregional adjuvant treatment for hepatocellular carcinoma with portal vein tumor thrombosis: A systematic review and Bayesian network meta-analysis.
发表日期：2023 Aug 01
作者：
Hao Sun, Bing Ma, Ning Sun, Han Bai, Xuejian Li, Chengshuo Zhang
来源：
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
摘要：
通过比较不同术中局部区域辅助治疗对原发性肝细胞癌（HCC）伴门静脉血栓（PVTT）的肿瘤学预后，以确定最佳策略。检索了电子数据库中相关研究。通过配对和网络荟萃分析合并了总生存率（OS）和无复发生存率（RFS）。共纳入了14个符合条件的试验，涉及1967名患者和四种治疗方法。所有与手术相结合的辅助治疗均明显优于单纯手术。放射治疗辅助疗法在OS（HR：0.38，95% Crl：0.25-0.57）和RFS（HR：0.27，95% Crl：0.11-0.65）方面的风险比最低，估计的累积排序面积分别为93.2%和82.7%。术中局部区域辅助治疗对于患有HCC伴PVTT的患者可提供OS益处并降低复发风险。放射治疗可能是最有效的辅助方案。版权所有©2023 Elsevier B.V.。保留所有权利。
To identify the optimal strategy for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) by comparing the oncological prognosis of different perioperative locoregional adjuvant treatments.Electronic database were searched for relevant studies. Overall survival (OS) and recurrence-free survival (RFS) were pooled by pairwise and network meta-analysis.Fourteen eligible trials with 1967 patients and covering four treatments were included. All adjuvant therapies in combination with surgery were shown to be superior to surgery alone. Adjuvant therapy with radiotherapy had the lowest hazard ratio (HR) for both OS (HR: 0.38, 95% Crl: 0.25-0.57) and RFS (HR: 0.27, 95% Crl: 0.11-0.65) compared with other combination treatments, with estimated surface under the cumulative ranking of 93.2% and 82.7%, respectively.Perioperative locoregional adjuvant therapy provides OS benefits and reduces the risk of recurrence for patients suffering from HCC with PVTT. Radiotherapy is likely to be the most effective adjuvant regimen.Copyright © 2023 Elsevier B.V. All rights reserved.