Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis
Repeat liver resection (RLR) has been adopted by surgeons as the first-line treatment in the case of intrahepatic recurrence of hepatocellular carcinoma (HCC), whereas salvage liver transplantation (SLT) is considered a second-line option. The aim of our study was to evaluate the results of SLT and...
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| Veröffentlicht in: | Transplantation proceedings 2019-03, Vol.51 (2), p.433-436 |
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| creator | Kostakis, I.D. Machairas, N. Prodromidou, A. Stamopoulos, P. Garoufalia, Z. Fouzas, I. Sotiropoulos, G.C. |
| description | Repeat liver resection (RLR) has been adopted by surgeons as the first-line treatment in the case of intrahepatic recurrence of hepatocellular carcinoma (HCC), whereas salvage liver transplantation (SLT) is considered a second-line option. The aim of our study was to evaluate the results of SLT and RLR for HCC.
We searched for articles published up to December 1, 2017, in the PubMed database that compared SLT with RLR for HCC. We extracted data about patient and tumor characteristics, operative and postoperative outcomes, and survival and performed a meta-analysis.
Patients who underwent SLT had somewhat larger liver lesions (mean difference: 0.73 cm, 95% confidence interval [CI]: 0.29–1.18, P = .001; I2: 0%, P = .82). Moreover, salvage liver transplantation resulted in higher blood loss, longer operating time, longer hospital stay, and higher postoperative morbidity (risk ratio [RR]: 2.45, 95% CI: 1.6–3.75, P |
| doi_str_mv | 10.1016/j.transproceed.2019.01.072 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2193623122</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0041134519301903</els_id><sourcerecordid>2193623122</sourcerecordid><originalsourceid>FETCH-LOGICAL-c380t-9208e3ef5659ce4834f7125e7567aa97b71f6a958c1c18f78040a6317ed289083</originalsourceid><addsrcrecordid>eNqNUctu1DAUtRCIDoVfQBErNgl-JLHdXRkeRRqE1Ja1devcII8SJ9jOVPMp_C2eRyWWrKyrex7X5xDyjtGKUdZ-2FYpgI9zmCxiV3HKdEVZRSV_RlZMSVHylovnZEVpzUom6uaCvIpxS_PMa_GSXAiqpG4avSJ_1tM4Q3Bx8sVHTI-IvriDYQe_sNi4HYbi_ug1gE-QXEaB74pbnBHSGXCLEe1x1U-HyS4hoE_FDc6Q8onDsAwQijUE6_w0wlVxXdztY8IxC9pM2Dl8PMp-xwQleBj20cXX5EUPQ8Q35_eS_Pzy-X59U25-fP22vt6UViiaSs2pQoF90zbaYq1E3UvGG5RNKwG0fJCsb0E3yjLLVC8VrSm0gknsuNJUiUvy_qSb8_y9YExmdPFwNXiclmg40yLHyTjP0KsT1IYpxoC9mYMbIewNo-ZQjdmaf6sxh2oMZSZXk8lvzz7Lw5h3T9SnLjLg0wmA-bc5k2Cidegtdi7kgE03uf_x-QvWM6kq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2193623122</pqid></control><display><type>article</type><title>Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Collection</source><creator>Kostakis, I.D. ; Machairas, N. ; Prodromidou, A. ; Stamopoulos, P. ; Garoufalia, Z. ; Fouzas, I. ; Sotiropoulos, G.C.</creator><creatorcontrib>Kostakis, I.D. ; Machairas, N. ; Prodromidou, A. ; Stamopoulos, P. ; Garoufalia, Z. ; Fouzas, I. ; Sotiropoulos, G.C.</creatorcontrib><description>Repeat liver resection (RLR) has been adopted by surgeons as the first-line treatment in the case of intrahepatic recurrence of hepatocellular carcinoma (HCC), whereas salvage liver transplantation (SLT) is considered a second-line option. The aim of our study was to evaluate the results of SLT and RLR for HCC.
We searched for articles published up to December 1, 2017, in the PubMed database that compared SLT with RLR for HCC. We extracted data about patient and tumor characteristics, operative and postoperative outcomes, and survival and performed a meta-analysis.
Patients who underwent SLT had somewhat larger liver lesions (mean difference: 0.73 cm, 95% confidence interval [CI]: 0.29–1.18, P = .001; I2: 0%, P = .82). Moreover, salvage liver transplantation resulted in higher blood loss, longer operating time, longer hospital stay, and higher postoperative morbidity (risk ratio [RR]: 2.45, 95% CI: 1.6–3.75, P < .0001; I2: 0%, P = .58) than RLR, whereas there was no significant difference in terms of postoperative mortality (RR: 6.48, 95% CI: 0.51–82.54, P = .15; I2: 61%, P = .08). On the other hand, SLT led to longer disease-free survival (DFS) than RLR (HR: 0.42, 95% CI: 0.25–0.7, P = .0009; I2: 63%, P = .03), but there was no significant difference in regard to overall survival (OS) (HR: 0.82, 95% CI: 0.55–1.23, P = .34; I2: 0%, P = .62).
SLT seems to be inferior to RLR regarding operative and postoperative results but presents a significant advantage in terms of DFS over RLR.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2019.01.072</identifier><identifier>PMID: 30879559</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - surgery ; Disease-Free Survival ; Female ; Hepatectomy ; Humans ; Liver Neoplasms - mortality ; Liver Neoplasms - surgery ; Liver Transplantation - methods ; Liver Transplantation - mortality ; Male ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - surgery ; Odds Ratio ; Progression-Free Survival ; Salvage Therapy - methods</subject><ispartof>Transplantation proceedings, 2019-03, Vol.51 (2), p.433-436</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-9208e3ef5659ce4834f7125e7567aa97b71f6a958c1c18f78040a6317ed289083</citedby><cites>FETCH-LOGICAL-c380t-9208e3ef5659ce4834f7125e7567aa97b71f6a958c1c18f78040a6317ed289083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0041134519301903$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30879559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kostakis, I.D.</creatorcontrib><creatorcontrib>Machairas, N.</creatorcontrib><creatorcontrib>Prodromidou, A.</creatorcontrib><creatorcontrib>Stamopoulos, P.</creatorcontrib><creatorcontrib>Garoufalia, Z.</creatorcontrib><creatorcontrib>Fouzas, I.</creatorcontrib><creatorcontrib>Sotiropoulos, G.C.</creatorcontrib><title>Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Repeat liver resection (RLR) has been adopted by surgeons as the first-line treatment in the case of intrahepatic recurrence of hepatocellular carcinoma (HCC), whereas salvage liver transplantation (SLT) is considered a second-line option. The aim of our study was to evaluate the results of SLT and RLR for HCC.
We searched for articles published up to December 1, 2017, in the PubMed database that compared SLT with RLR for HCC. We extracted data about patient and tumor characteristics, operative and postoperative outcomes, and survival and performed a meta-analysis.
Patients who underwent SLT had somewhat larger liver lesions (mean difference: 0.73 cm, 95% confidence interval [CI]: 0.29–1.18, P = .001; I2: 0%, P = .82). Moreover, salvage liver transplantation resulted in higher blood loss, longer operating time, longer hospital stay, and higher postoperative morbidity (risk ratio [RR]: 2.45, 95% CI: 1.6–3.75, P < .0001; I2: 0%, P = .58) than RLR, whereas there was no significant difference in terms of postoperative mortality (RR: 6.48, 95% CI: 0.51–82.54, P = .15; I2: 61%, P = .08). On the other hand, SLT led to longer disease-free survival (DFS) than RLR (HR: 0.42, 95% CI: 0.25–0.7, P = .0009; I2: 63%, P = .03), but there was no significant difference in regard to overall survival (OS) (HR: 0.82, 95% CI: 0.55–1.23, P = .34; I2: 0%, P = .62).
SLT seems to be inferior to RLR regarding operative and postoperative results but presents a significant advantage in terms of DFS over RLR.</description><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver Transplantation - methods</subject><subject>Liver Transplantation - mortality</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Odds Ratio</subject><subject>Progression-Free Survival</subject><subject>Salvage Therapy - methods</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUctu1DAUtRCIDoVfQBErNgl-JLHdXRkeRRqE1Ja1devcII8SJ9jOVPMp_C2eRyWWrKyrex7X5xDyjtGKUdZ-2FYpgI9zmCxiV3HKdEVZRSV_RlZMSVHylovnZEVpzUom6uaCvIpxS_PMa_GSXAiqpG4avSJ_1tM4Q3Bx8sVHTI-IvriDYQe_sNi4HYbi_ug1gE-QXEaB74pbnBHSGXCLEe1x1U-HyS4hoE_FDc6Q8onDsAwQijUE6_w0wlVxXdztY8IxC9pM2Dl8PMp-xwQleBj20cXX5EUPQ8Q35_eS_Pzy-X59U25-fP22vt6UViiaSs2pQoF90zbaYq1E3UvGG5RNKwG0fJCsb0E3yjLLVC8VrSm0gknsuNJUiUvy_qSb8_y9YExmdPFwNXiclmg40yLHyTjP0KsT1IYpxoC9mYMbIewNo-ZQjdmaf6sxh2oMZSZXk8lvzz7Lw5h3T9SnLjLg0wmA-bc5k2Cidegtdi7kgE03uf_x-QvWM6kq</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Kostakis, I.D.</creator><creator>Machairas, N.</creator><creator>Prodromidou, A.</creator><creator>Stamopoulos, P.</creator><creator>Garoufalia, Z.</creator><creator>Fouzas, I.</creator><creator>Sotiropoulos, G.C.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201903</creationdate><title>Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis</title><author>Kostakis, I.D. ; Machairas, N. ; Prodromidou, A. ; Stamopoulos, P. ; Garoufalia, Z. ; Fouzas, I. ; Sotiropoulos, G.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-9208e3ef5659ce4834f7125e7567aa97b71f6a958c1c18f78040a6317ed289083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver Transplantation - methods</topic><topic>Liver Transplantation - mortality</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Odds Ratio</topic><topic>Progression-Free Survival</topic><topic>Salvage Therapy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kostakis, I.D.</creatorcontrib><creatorcontrib>Machairas, N.</creatorcontrib><creatorcontrib>Prodromidou, A.</creatorcontrib><creatorcontrib>Stamopoulos, P.</creatorcontrib><creatorcontrib>Garoufalia, Z.</creatorcontrib><creatorcontrib>Fouzas, I.</creatorcontrib><creatorcontrib>Sotiropoulos, G.C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kostakis, I.D.</au><au>Machairas, N.</au><au>Prodromidou, A.</au><au>Stamopoulos, P.</au><au>Garoufalia, Z.</au><au>Fouzas, I.</au><au>Sotiropoulos, G.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2019-03</date><risdate>2019</risdate><volume>51</volume><issue>2</issue><spage>433</spage><epage>436</epage><pages>433-436</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><abstract>Repeat liver resection (RLR) has been adopted by surgeons as the first-line treatment in the case of intrahepatic recurrence of hepatocellular carcinoma (HCC), whereas salvage liver transplantation (SLT) is considered a second-line option. The aim of our study was to evaluate the results of SLT and RLR for HCC.
We searched for articles published up to December 1, 2017, in the PubMed database that compared SLT with RLR for HCC. We extracted data about patient and tumor characteristics, operative and postoperative outcomes, and survival and performed a meta-analysis.
Patients who underwent SLT had somewhat larger liver lesions (mean difference: 0.73 cm, 95% confidence interval [CI]: 0.29–1.18, P = .001; I2: 0%, P = .82). Moreover, salvage liver transplantation resulted in higher blood loss, longer operating time, longer hospital stay, and higher postoperative morbidity (risk ratio [RR]: 2.45, 95% CI: 1.6–3.75, P < .0001; I2: 0%, P = .58) than RLR, whereas there was no significant difference in terms of postoperative mortality (RR: 6.48, 95% CI: 0.51–82.54, P = .15; I2: 61%, P = .08). On the other hand, SLT led to longer disease-free survival (DFS) than RLR (HR: 0.42, 95% CI: 0.25–0.7, P = .0009; I2: 63%, P = .03), but there was no significant difference in regard to overall survival (OS) (HR: 0.82, 95% CI: 0.55–1.23, P = .34; I2: 0%, P = .62).
SLT seems to be inferior to RLR regarding operative and postoperative results but presents a significant advantage in terms of DFS over RLR.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30879559</pmid><doi>10.1016/j.transproceed.2019.01.072</doi><tpages>4</tpages></addata></record> |
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| ispartof | Transplantation proceedings, 2019-03, Vol.51 (2), p.433-436 |
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| subjects | Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - surgery Disease-Free Survival Female Hepatectomy Humans Liver Neoplasms - mortality Liver Neoplasms - surgery Liver Transplantation - methods Liver Transplantation - mortality Male Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - surgery Odds Ratio Progression-Free Survival Salvage Therapy - methods |
| title | Comparison Between Salvage Liver Transplantation and Repeat Liver Resection for Recurrent Hepatocellular Carcinoma: A Systematic Review and Meta-analysis |
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