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. 2016 Jan 28:16:11.
doi: 10.1186/s12876-016-0427-2.

Surgical outcomes of hepatocellular carcinoma with biliary tumor thrombus: a systematic review

Wenhui Qiao  1 , Feng Yu  2 , Lupeng Wu  3 , Bin Li  4 , Yanming Zhou  5
Affiliations

Surgical outcomes of hepatocellular carcinoma with biliary tumor thrombus: a systematic review

Wenhui Qiao et al. BMC Gastroenterol. .

Abstract

Background: Hepatocellular carcinoma (HCC) with biliary tumor thrombus (BTT) is rare and its impact on postoperative prognosis remains controversial. The aim of this study was to evaluate the published evidence concerning the outcome of surgical resection of HCC with BTT.

Methods: Eligible studies were identified by searching PubMed and reviewed systematically. Comparisons of the clinicopathologic features and surgical outcomes for HCC patients with or without BTT were analyzed using meta-analytical techniques.

Results: Twenty retrospective studies containing 598 patients that met the selection criteria were included for review. The perioperative mortality was 2.1 % (range, 0-10 %), and the median 5-year overall survival (OS) was 24 % (range, 0-48 %) with a recurrence rate of 63.9 % (range, 42-91 %). Pooled analysis of 13 comparative studies showed that HCC patients with BTT had a higher incidence of vascular invasion (odds ratio [OR]: 4.70, 95 % CI: 2.90-7.60; P <0.001), a higher frequency of poor differentiation (OR: 2.07, 95 % CI: 1.23-3.49; P = 0.006), and a shorter 5-year OS rate (OR: 0.31, 95 % CI: 0.21-0.64; P <0.001) than those without BTT.

Conclusions: Although HCC with BTT has more aggressive biological characteristics and is an indicator of poor prognosis, surgical resection can still provide long-term survival for some patients.

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Figures

Fig. 1
Fig. 1
Result of the meta-analysis on 1-year overall survival
Fig. 2
Fig. 2
Result of the meta-analysis on 3-year overall survival
Fig. 3
Fig. 3
Result of the meta-analysis on 5-year overall survival
Fig. 4
Fig. 4
Funnel plot analysis of publication bias. The outcome was the 1-year overall survival
See this image and copyright information in PMC

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