Hepatic Resection Improved the Long-Term Survival of Patients with BCLC Stage B Hepatocellular Carcinoma in Asia: a Systematic Review and Meta-Analysis

2015 ◽  
Vol 19 (7) ◽  
pp. 1271-1280 ◽  
Author(s):  
Wei Liu ◽  
Jian-Guo Zhou ◽  
Yi Sun ◽  
Lei Zhang ◽  
Bao-Cai Xing
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Hepatic Resection ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival

scholarly journals P75 Long-Term Survival After Minimally Invasive Resection versus Open Resection for Hepatocellular Carcinoma: A Systematic Review, Meta-Analysis and Meta-Regression

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Rohan R Gujjuri ◽  
Sivesh K Kamarajah ◽  
Moh’d Abu Hilal ◽  
Derek M Manas ◽  
Steven A White ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Minimally Invasive ◽  
Liver Surgery ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival ◽  
Meta Regression ◽  
Disease Specific

Abstract Introduction Minimally invasive liver surgery (MILS) for hepatocellular carcinoma (HCC) has gained widespread interest as an alternative to conventional open liver surgery (OLS). However, long-term survival benefits of this approach seem unclear. This meta- analysis was conducted to investigate long-term survival following MILS. Methods A systematic review was performed to identify studies comparing long-term survival after MILS and OLS until January 2020. The I2 test was used to test for statistical heterogeneity and publication bias was assessed using Egger test. Random-effects meta-analysis was performed for all-cause 5-year (main outcome) and 3-year mortality, and disease-specific 5-year and 3-year mortality. Meta-regression was performed for the 5-year and 3-year survival outcomes with adjustment for study factors (region, design), annual center volume, patient factors (ASA grade, gender, age, BMI, cirrhosis, tumor size and number), and resection extent. Sensitivity analyses were performed on studies by study year, region, annual centre volume, resection type. Results The review identified 50 relevant studies including 13,731 patients undergoing liver resection for HCC of which 4,071 (25.8%) underwent MILS. Pooled analysis revealed similar all-cause (OR: 0.83, 95% CI: 0.70 - 1.11, p = 0.3) and disease-specific (OR: 0.93, 95% CI: 0.80 - 1.09, p = 0.4) 5-year mortality after MILS compared with OLS. Sensitivity analysis of published studies from 2010 to 2019 demonstrated a significantly lower disease-specific 3-year mortality (OR 0.75, 95% CI: 0.59 - 0.96, p = 0.022) and all cause 5-year mortality (OR 0.63, 95% CI: 0.50 - 0.81, p = 0.002). Meta- regression identified no confounding factors in all analyses. Conclusions Improvement in MILS techniques over the past decade appears to demonstrate superior disease-specific mortality with MILS compared to OLS. Therefore, MILS can be recommended as a standard surgical approach for HCC.

665 PROPHYLACTIC THORACIC DUCT OBSTRUCTION DURING ESOPHAGECTOMY: THE IMPACT ON PERIOPERATIVE RISKS AND LONG-TERM SURVIVAL. A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Clara Santos ◽  
Laura Santos ◽  
Leticia Datrino ◽  
Guilherme Tavares ◽  
Luca Tristão ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Thoracic Duct ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival ◽  
Thoracic Duct Ligation ◽  
Duct Ligation

Abstract   During esophagectomy for cancer, there is no consensus if prophylactic thoracic duct ligation (TDL), with or without thoracic duct resection (TDR), could influence the perioperative outcomes and long-term survival. This systematic review and meta-analysis compared patients who went through esophagectomy associated or not to ligation or resection of the thoracic duct. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central and Lilacs (BVS). The inclusion criteria were: (1) studies that compare thoracic duct ligation, with or without resection, and non-thoracic duct ligation; (2) involve adult patients with esophageal cancer; (3) articles that analyses the outcomes—perioperative complications, perioperative mortality, chylothorax development and overall survival; (4) only clinical trials and cohort were accepted. A 95% confidence interval (CI) was used, and random-effects model was performed. Results Fifteen articles were selected, comprising 6,249 patients. TDL did not reduce the risk for chylothorax (Risk difference [RD]: -0.01; 95%CI: −0.02, 0.00). Also, TDL did not influence the risk for complications (RD: -0.02; 95%CI: −0.11, 0.07); mortality (RD: 0.00; 95%CI: −0.00, 0.00); and reoperation rate (RD: -0.01; 95%CI: −0.02, 0.00). TDR was associated with higher risk for postoperative complications (RD: 0.1; 95%CI 0.00, 0.19); chylothorax (RD: 0.02; 95%CI 0.00, 0.03). Both TDL and TDR did not influence the overall survival rate (TDL: HR: 1.17; 95%CI: 0.86, 1.48; and TDR: HR: 1.16; 95%CI: 0.8, 1.51). Conclusion Thoracic duct obliteration with or without its resection during esophagectomy does not change long term survival. Nonetheless, TDR increased the risk for postoperative complications and chylothorax.

658 HEPATIC RESECTION CAN PROVIDE LONG-TERM SURVIVAL OF PATIENTS IN BARCELONA CLINICAL LIVER CANCER STAGE B OR C HEPATOCELLULAR CARCINOMA

2011 ◽  
Vol 54 ◽  
pp. S265-S266
Author(s):  
C.-W. Su ◽  
G.-Y. Chau ◽  
C.-Y. Hsia ◽  
J.-C. Wu ◽  
T.-I. Huo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Hepatic Resection ◽  
Cancer Stage ◽  
Term Survival ◽  
Long Term Survival

723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Letícia Nogueira Datrino ◽  
Clara Lucato Santos ◽  
Guilherme Tavares ◽  
Luca Schiliró Tristão ◽  
Maria Carolina Andrade Serafim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Meta Analysis ◽  
Operation Time ◽  
Extended Lymphadenectomy ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Long Term Survival ◽  
Short And Long Term

Abstract   Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (>18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

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