Clinical effect of salvage liver transplantation in the treatment of recurrent hepatocellular carcinoma after hepatectomy: a systematic review

doi:10.3877/cma.j.issn.1674-3903.2017.03.011

Abstract

Abstract:

Objective

To evaluate the clinical efficacy of salvage liver transplantation (SLT) for hepatocellular carcinoma.

Methods

Information up to August 31th 2016 was retrieved from Cochrane library, Pubmed, EMbase, CBM, CNKI, CSPD and VIP without linguistic constraints. Collected publications were all about case-control study of SLT or primary liver transplantation for hepatocellular carcinoma. All the included articles were performed with data extraction and quality assessment and then analyzed with RevMan 5.3.

Results

A total of 17 articles including 9 335 patients were enrolled. There was no statistic difference between SLT and PLT on 1-year survival rate, 1-year disease-free survival rate (RR=0.93, 95%CI: 0.80-1.08, P=0.36; RR=0.94, 95%CI: 0.81-1.08, P=0.40). However, 3-year survival rate and 5-year disease-free survival rate of PLT were higher than SLT(RR=0.88, 95%CI: 0.77-1.00, P=0.04; RR=0.86, 95%CI: 0.76-0.98, P=0.02; RR=0.83, 95%CI: 0.73-0.94, P=0.005; RR=0.77, 95%CI: 0.67-0.88, P=0.001).

Conclusion

Long-term efficacy of PLT was better than SLT.

Key words: Primary hepatic carcinoma, Salvage liver transplantation, Recurrent hepatocellular carcinoma, Systematic review

Hongliang Wang, Jianhui Dong, Liugen Lan, Ke Qin, Meisi Li, Haibin Li, Zhuangjiang Li, Xuyong Sun. Clinical effect of salvage liver transplantation in the treatment of recurrent hepatocellular carcinoma after hepatectomy: a systematic review[J]. Chinese Journal of Transplantation(Electronic Edition), 2017, 11(03): 177-183.

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Figures/Tables 4

References 25

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纳入研究	国家	例数	年龄(岁)	性别(例)	符合米兰标准人数(例)	结局指标	并发症
纳入研究	国家	SLT/PLT	SLT/PLT	男/女	SLT/PLT	结局指标	并发症
Abe等^[3]	日本	15/45	46.7～53.3/46.7～53.3	48/12	5/26	总生存率，无瘤生存率	胆道并发症，术后出血，腹腔脓肿
Vennarecci等^[4]	意大利	9/37	未描述	未描述	未描述	总生存率，无瘤生存率	胆道并发症，术后出血，脓毒血症，动脉血栓，急性排斥反应
Gaudio等^[5]	意大利	16/147	54±8/55±7	139/24	未描述	总生存率，无瘤生存率	胆道并发症，血管并发症，神经系统并发症，感染，再次移植
Moon等^[6]	韩国	17/169	51/52	155/31	12/109	总生存率，无瘤生存率	术后出血，动脉血栓，胆道并发症，再次移植
Guerrini等^[7]	意大利	28/198	56±10/56±7	196/30	22/133	总生存率，无瘤生存率	未描述
Wu等^[8]	中国	36/147	49.4±17.1/47.6±15.8	133/50	未描述/147	总生存率，无瘤生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，血管并发症
Liu等^[9]	中国	39/180	44/47	198/21	20/122	总生存率	出血，感染，急性排斥反应，胆道并发症，血管并发症
Hu等^[10]	中国	888/6 087	49.7/50.0	6 268/707	未描述	总生存率，无瘤生存率	腹腔脓肿，急性排斥反应，胆道并发症，血管并发症，肾衰竭
Hwang等^[11]	韩国	17/200	49.3±8.6/51.2±7.0	170/47	10/158	总生存率	出血，腹腔脓肿，胆道并发症，血管并发症
Bhangui等^[12]	法国	31/340	未描述/37～63	未描述	未描述	总生存率，无瘤生存率	未描述
常虎林等^[13]	中国	8/60	46±10/49±8	64/4	3/未描述	总生存率，无瘤生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症
江艺等^[14]	中国	13/32	47/2.3	31/14	13/32	总生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，急性胰腺炎
夏玉健等^[15]	中国	12/41	50.7±11.4/52.6±10.8	43/10	12/41	总生存率	未描述
张彤等^[16]	中国	19/42	45.1±13.2/52.5±9.6	57/4	19/42	总生存率，无瘤生存率	腹腔出血再手术，胆道并发症，急性排斥反应
杨国欢等^[17]	中国	26/71	50.27±8.58	90/7	26/71	总生存率	未描述
张建军等^[18]	中国	11/65	45±6.5/42±7.2	61/15	未描述	总生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，再手术
王征等^[19]	中国	47/242	49.9±9.5/47.7±8.2	216/73	未描述	总生存率，无瘤生存率	未描述

纳入研究	国家	例数	年龄(岁)	性别(例)	符合米兰标准人数(例)	结局指标	并发症
纳入研究	国家	SLT/PLT	SLT/PLT	男/女	SLT/PLT	结局指标	并发症
Abe等^[3]	日本	15/45	46.7～53.3/46.7～53.3	48/12	5/26	总生存率，无瘤生存率	胆道并发症，术后出血，腹腔脓肿
Vennarecci等^[4]	意大利	9/37	未描述	未描述	未描述	总生存率，无瘤生存率	胆道并发症，术后出血，脓毒血症，动脉血栓，急性排斥反应
Gaudio等^[5]	意大利	16/147	54±8/55±7	139/24	未描述	总生存率，无瘤生存率	胆道并发症，血管并发症，神经系统并发症，感染，再次移植
Moon等^[6]	韩国	17/169	51/52	155/31	12/109	总生存率，无瘤生存率	术后出血，动脉血栓，胆道并发症，再次移植
Guerrini等^[7]	意大利	28/198	56±10/56±7	196/30	22/133	总生存率，无瘤生存率	未描述
Wu等^[8]	中国	36/147	49.4±17.1/47.6±15.8	133/50	未描述/147	总生存率，无瘤生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，血管并发症
Liu等^[9]	中国	39/180	44/47	198/21	20/122	总生存率	出血，感染，急性排斥反应，胆道并发症，血管并发症
Hu等^[10]	中国	888/6 087	49.7/50.0	6 268/707	未描述	总生存率，无瘤生存率	腹腔脓肿，急性排斥反应，胆道并发症，血管并发症，肾衰竭
Hwang等^[11]	韩国	17/200	49.3±8.6/51.2±7.0	170/47	10/158	总生存率	出血，腹腔脓肿，胆道并发症，血管并发症
Bhangui等^[12]	法国	31/340	未描述/37～63	未描述	未描述	总生存率，无瘤生存率	未描述
常虎林等^[13]	中国	8/60	46±10/49±8	64/4	3/未描述	总生存率，无瘤生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症
江艺等^[14]	中国	13/32	47/2.3	31/14	13/32	总生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，急性胰腺炎
夏玉健等^[15]	中国	12/41	50.7±11.4/52.6±10.8	43/10	12/41	总生存率	未描述
张彤等^[16]	中国	19/42	45.1±13.2/52.5±9.6	57/4	19/42	总生存率，无瘤生存率	腹腔出血再手术，胆道并发症，急性排斥反应
杨国欢等^[17]	中国	26/71	50.27±8.58	90/7	26/71	总生存率	未描述
张建军等^[18]	中国	11/65	45±6.5/42±7.2	61/15	未描述	总生存率	出血，感染，急性排斥反应，肾衰竭，胆道并发症，再手术
王征等^[19]	中国	47/242	49.9±9.5/47.7±8.2	216/73	未描述	总生存率，无瘤生存率	未描述

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