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Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis

BACKGROUND: The optimal surgical modality for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) remains controversial, especially regarding deciding whether to perform concurrent bile duct resection (BDR). METHODS: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databas...

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Autores principales: Feng, Jin-Kai, Chen, Zhen-Hua, Wu, Yu-Xuan, Wang, Kang, Sun, Ju-Xian, Chai, Zong-Tao, Guo, Wei-Xing, Shi, Jie, Cheng, Shu-Qun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791268/
https://www.ncbi.nlm.nih.gov/pubmed/33437766
http://dx.doi.org/10.21037/atm-20-3935
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author Feng, Jin-Kai
Chen, Zhen-Hua
Wu, Yu-Xuan
Wang, Kang
Sun, Ju-Xian
Chai, Zong-Tao
Guo, Wei-Xing
Shi, Jie
Cheng, Shu-Qun
author_facet Feng, Jin-Kai
Chen, Zhen-Hua
Wu, Yu-Xuan
Wang, Kang
Sun, Ju-Xian
Chai, Zong-Tao
Guo, Wei-Xing
Shi, Jie
Cheng, Shu-Qun
author_sort Feng, Jin-Kai
collection PubMed
description BACKGROUND: The optimal surgical modality for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) remains controversial, especially regarding deciding whether to perform concurrent bile duct resection (BDR). METHODS: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databases were systematically searched from inception to February 2020, in order to compare overall survival (OS) and recurrence-free survival (RFS) rates of HCC patients with BDTT who had either received hepatectomy with extrahepatic bile duct resection (BDR group) or hepatectomy without bile duct resection (NBDR group). Relevant outcomes were extracted by two investigators. RESULTS: A total of 12 studies involving 355 patients was included. The 1-, 3- and 5-year OS rates were similar in the BDR and NBDR groups (OR =0.58, 95% CI: 0.31–1.09, P=0.09; OR =0.74, 95% CI: 0.43–1.28, P=0.28; OR =0.63, 95% CI: 0.36–1.11, P=0.11, respectively). However, the BDR group had better 1-, 3- and 5-year RFS rates than the NBDR group (OR =0.38, 95% CI: 0.22–0.65, P<0.01; OR =0.40, 95% CI: 0.22–0.72, P<0.01; OR =0.37, 95% CI: 0.19–0.71, P<0.01, respectively). CONCLUSIONS: Concomitant bile duct resection results in decreased postoperative recurrence in HCC patients with BDTT. However, the OS rates were similar whether or not patients underwent bile duct resection.
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spelling pubmed-77912682021-01-11 Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis Feng, Jin-Kai Chen, Zhen-Hua Wu, Yu-Xuan Wang, Kang Sun, Ju-Xian Chai, Zong-Tao Guo, Wei-Xing Shi, Jie Cheng, Shu-Qun Ann Transl Med Original Article BACKGROUND: The optimal surgical modality for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) remains controversial, especially regarding deciding whether to perform concurrent bile duct resection (BDR). METHODS: PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databases were systematically searched from inception to February 2020, in order to compare overall survival (OS) and recurrence-free survival (RFS) rates of HCC patients with BDTT who had either received hepatectomy with extrahepatic bile duct resection (BDR group) or hepatectomy without bile duct resection (NBDR group). Relevant outcomes were extracted by two investigators. RESULTS: A total of 12 studies involving 355 patients was included. The 1-, 3- and 5-year OS rates were similar in the BDR and NBDR groups (OR =0.58, 95% CI: 0.31–1.09, P=0.09; OR =0.74, 95% CI: 0.43–1.28, P=0.28; OR =0.63, 95% CI: 0.36–1.11, P=0.11, respectively). However, the BDR group had better 1-, 3- and 5-year RFS rates than the NBDR group (OR =0.38, 95% CI: 0.22–0.65, P<0.01; OR =0.40, 95% CI: 0.22–0.72, P<0.01; OR =0.37, 95% CI: 0.19–0.71, P<0.01, respectively). CONCLUSIONS: Concomitant bile duct resection results in decreased postoperative recurrence in HCC patients with BDTT. However, the OS rates were similar whether or not patients underwent bile duct resection. AME Publishing Company 2020-12 /pmc/articles/PMC7791268/ /pubmed/33437766 http://dx.doi.org/10.21037/atm-20-3935 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Feng, Jin-Kai
Chen, Zhen-Hua
Wu, Yu-Xuan
Wang, Kang
Sun, Ju-Xian
Chai, Zong-Tao
Guo, Wei-Xing
Shi, Jie
Cheng, Shu-Qun
Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title_full Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title_fullStr Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title_full_unstemmed Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title_short Comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
title_sort comparison of different surgical interventions for hepatocellular carcinoma with bile duct tumor thrombus: a systematic review and meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791268/
https://www.ncbi.nlm.nih.gov/pubmed/33437766
http://dx.doi.org/10.21037/atm-20-3935
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