Survival benefits from adjuvant transcatheter arterial chemoembolization in patients undergoing liver resection for hepatocellular carcinoma: a systematic review and meta-analysis

• Published in: Therapeutic Advances in Gastroenterology 2020, Vol.13, p.1756284820977693-1756284820977693
• Main Authors: Liang, Lei, Li, Chao, Diao, Yong-Kang, Jia, Hang-Dong, Xing, Hao, Pawlik, Timothy M., Lau, Wan Yee, Shen, Feng, Huang, Dong-Sheng, Zhang, Cheng-Wu, Yang, Tian
• Format: Article
• Language: English
• Subjects: Chemoembolization; Diagnosis, Management, and Prognostic Assessment of Liver Cancer; Gastroenterology; Hepatectomy; Liver cancer; Meta-analysis
• ISSN: 1756-2848; 1756-283X; 1756-2848
• DOI: 10.1177/1756284820977693

Background: Although adjuvant transcatheter arterial chemoembolization (TACE) has been used to prevent recurrence after surgery in patients with hepatocellular carcinoma (HCC), the survival benefits from adjuvant TACE remain controversial. We sought to systematically evaluate the data on the effectiveness of adjuvant TACE for HCC, as well as identify patient populations that might benefit from adjuvant TACE. Methods: The PubMed, Embase, Medline and Cochrane library were systematically searched for studies published before July 2019 that compared adjuvant TACE versus surgery alone for HCC. The study endpoints were overall survival (OS) and disease-free survival (DFS). Patients with large HCC (⩾5 cm), multinodular HCC, microvascular invasion (MVI), or portal vein tumor thrombosis (PVTT) were analyzed in subgroup analyses. Results: Twenty-four studies with 6977 patients were included in the analytic cohort. The pooled analysis demonstrated that adjuvant TACE was associated with a better OS and DFS [hazard ratio (HR): 0.67 and 0.67, both p