Survival benefit of perioperative locoregional adjuvant treatment for hepatocellular carcinoma with portal vein tumor thrombosis: A systematic review and Bayesian network meta-analysis

Hao Sun; Bing Ma; Ning Sun; Han Bai; Xuejian Li; Chengshuo Zhang

doi:10.1016/j.critrevonc.2023.104083

Survival benefit of perioperative locoregional adjuvant treatment for hepatocellular carcinoma with portal vein tumor thrombosis: A systematic review and Bayesian network meta-analysis

Crit Rev Oncol Hematol. 2023 Sep:189:104083. doi: 10.1016/j.critrevonc.2023.104083. Epub 2023 Aug 1.

Authors

Hao Sun¹, Bing Ma¹, Ning Sun², Han Bai², Xuejian Li², Chengshuo Zhang³

Affiliations

¹ Department of Clinical Epidemiology and Evidence-Based Medicine, the First Hospital of China Medical University, Shenyang, China.
² Department of Hepatobiliary Surgery, the First Hospital of China Medical University, Shenyang, China.
³ Department of Hepatobiliary Surgery, the First Hospital of China Medical University, Shenyang, China. Electronic address: cszhang@cmu.edu.cn.

PMID: 37536447
DOI: 10.1016/j.critrevonc.2023.104083

Abstract

Background: To identify the optimal strategy for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) by comparing the oncological prognosis of different perioperative locoregional adjuvant treatments.

Methods: Electronic database were searched for relevant studies. Overall survival (OS) and recurrence-free survival (RFS) were pooled by pairwise and network meta-analysis.

Results: Fourteen eligible trials with 1927 patients and covering four adjuvant treatments were included. All adjuvant therapies in combination with surgery were shown to be superior to surgery alone. Adjuvant therapy with radiotherapy had the lowest hazard ratio (HR) for both OS (HR: 0.38, 95% CrI: 0.25-0.57) and RFS (HR: 0.27, 95% CrI: 0.11-0.65) compared with other combination treatments, with estimated surface under the cumulative ranking of 93.2% and 82.7%, respectively.

Conclusions: Perioperative locoregional adjuvant therapy provides OS benefits and reduces the risk of recurrence for patients suffering from HCC with PVTT. Radiotherapy is likely to be the most effective adjuvant regimen.

Keywords: Adjuvant therapy; Hepatocellular carcinoma (HCC); Network meta-analysis; Portal vein tumor thrombosis (PVTT); Radiotherapy.

Publication types

Review