Survival outcomes after caudate lobectomy for hepatocellular carcinoma: systematic review and meta-analysis
Abdulahad Abdulrab Moahmmed Al-Ameri MBBS, MS, MD
Department of Hepatobiliaryand Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China
National Health Commission Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China
Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences, Hangzhou, China
Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, China
Search for more papers by this authorCorresponding Author
Shusen Zheng MD, PhD, FACS
Department of Hepatobiliaryand Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China
National Health Commission Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China
Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences, Hangzhou, China
Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, China
Correspondence
Prof. Shusen Zheng, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Supervision, Writing - review & editing
Search for more papers by this authorAbdulahad Abdulrab Moahmmed Al-Ameri MBBS, MS, MD
Department of Hepatobiliaryand Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China
National Health Commission Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China
Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences, Hangzhou, China
Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, China
Search for more papers by this authorCorresponding Author
Shusen Zheng MD, PhD, FACS
Department of Hepatobiliaryand Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China
National Health Commission Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, China
Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Research Unit of Collaborative Diagnosis and Treatment For Hepatobiliary and Pancreatic Cancer, Chinese Academy of Medical Sciences, Hangzhou, China
Key Laboratory of Organ Transplantation, Research Center for Diagnosis and Treatment of Hepatobiliary Diseases, Hangzhou, China
Correspondence
Prof. Shusen Zheng, Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Email: [email protected]
Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Supervision, Writing - review & editing
Search for more papers by this authorAbstract
Background
Caudate lobectomy (CLB) remains the most effective treatment for caudate lobe hepatocellular carcinoma (CL-HCC). However, there is controversy regarding the survival after CLB. This meta-analysis aims to investigate the survival outcomes following CLB for the treatment of CL-HCC.
Methods
In line with PRISMA and MOOSE guidelines, a search for all eligible studies was performed. The pooled estimates of survival rates and hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using fixed- or random-effects models.
Results
Sixteen studies comprising 864 patients met the inclusion criteria. The pooled estimates of 3- and 5-year overall survival (OS) rates were 62.3% and 42.9% respectively and the pooled estimate of 3- and 5-year recurrence-free survival (RFS) rates were 39.3% and 24.4% respectively. CL-HCC showed inferior OS (HR:1.39, 95% CI: 0.91–1.88, P < 0.001) and RFS (HR:1.33, 95% CI: 1.10–1.56, P < 0.001) than other sites HCC. Isolated CLB showed better OS (HR:0.9, 95% CI:0.39–1.41, p < 0.001) and RFS (HR:0.76, 95% CI: 0.03–1.5, P = 0.04) than combined CLB.
Conclusions
The survival outcomes for CL-HCC after CLB are lower compared to other sites HCC. Isolated CLB offers better survival outcomes compared to combined CLB. However, choosing isolated or combined approaches should be prioritized according to patient and tumour characteristics.
Conflict of interest
None declared.
Supporting Information
| Filename | Description |
|---|---|
| ans18860-sup-0001-DocS1.docxWord 2007 document , 38.2 KB | Data S1 Doc S1: Detailed search strategy and list of studies that were excluded due to overlapping and/or no survival data. |
| ans18860-sup-0002-supinfo.docxWord 2007 document , 441.6 KB | Table S1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. Table S2. MOOSE (Meta-analyses Of Observational Studies in Epidemiology) Checklist. Table S3. Summary of survival data among included studies. Table S4. Overall survival data of caudate lobe HCC versus other sites HCC. Table S5. Recurrence-free survival data of caudate lobe HCC versus other sites HCC. Table S6. Overall survival data of isolated caudate lobectomy versus combined caudate lobectomy. Table S7. Recurrence free survival of isolated caudate lobectomy versus combined caudate lobectomy. Figure S1. Funnel plot of the 3-year OS among included studies. Figure S2. Funnel plot of the 5-year overall survival among included studies. Figure S3. Funnel plot of the 3-year recurrence-free survival among included studies. Figure S4. Funnel plot of the 5-year recurrence-free survival among included studies. Figure S5. Funnel plot of the overall survival among studies compared caudate lobe HCC versus other sites HCC. Figure S6. Funnel plot of the recurrence-free survival among studies compared caudate lobe HCC versus other sites HCC. Figure S7. Funnel plot of the overall survival among studies compared isolated caudate lobectomy versus combined caudate lobectomy. Figure S8. Funnel plot of the recurrence free survival among studies compared isolated caudate lobectomy versus combined caudate lobectomy. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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