Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Recent advances in surgical techniques and perioperative management have been suggested to have improved survival. However, full agreement about the overall survival ofpatient with multinodular HCC is still not reached yet. The aim of this meta-analysis is to evaluate the survival of patients with multinodular HCC undergoing recent treatment modalities.Weperformed the systematic computerized search for eligible articles fromfour databases (PubMed, Embase, Google Scholar and Web of Science) published before February 2018. Summary effect size (ES) and 95% confidence interval (CI) were calculated with the random-effects model and fixed-effects model. A total of 25 studies with 18954 multinodular hepatocellular carcinoma patients were included. Overall survival was shorter inpatient having multinodular carcinoma undergoing different treatment modalities (ES 1.12, 95 % CI 1.02 to 1.21; p=0.000) which was statistically significant. Those undergoing hepatectomy was shorter (ES 1.49, 95% CI 1.33 to 1.64; p=0.304) which was not statistically significantand patients undergoing RFA was shorter (ES 1.61, 95% CI 1.28 to 1.94; p=0.020) which was statistically significant. Begg’s funnel plot showed no publication bias exists.Our meta-analysis result showed that the overall survival of patients with multinodular carcinoma is shorter.
Perioperative management based on ESSENSE protocol in patients undergoing resection of hepatocellular carcinoma
