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. 2017 Jan 17;8(3):5460-5473.
doi: 10.18632/oncotarget.12348.

A mixed analysis comparing nine minimally invasive surgeries for unresectable hepatocellular carcinoma patients

Ran Tao  1 , Xiaodan Li  2 , Ruizhi Ran  3 , Zhihua Xiao  4 , Hongyue Zhang  1 , Hongyan Kong  1 , Qiqin Song  1 , Yu Huang  1 , Likui Wang  5 , Jiaquan Huang  1
Affiliations

A mixed analysis comparing nine minimally invasive surgeries for unresectable hepatocellular carcinoma patients

Ran Tao et al. Oncotarget. .

Abstract

Hepatocellular carcinoma (HCC) is usually managed by the transcatheter arterial chemoembolization (TACE). However, this technique has been challenged since severe complications have been observed in clinical practices. As a result, clinicians have started to seek other minimally invasive surgeries with equivalent efficacy. The corresponding surgeries were assessed by the five outcomes: complete response (CR), partial response (PR), stable disease (SD), progression disease (PD) and objective response rate (ORR). Direct meta-analysis and network meta-analysis were performed and the results were represented by odds ratios (OR), 95% confidence and credential intervals. Furthermore, the value of surface under the cumulative ranking curve (SUCRA)was calculated to provide corresponding rankings.Seventeen studies were incorporated into the network meta-analysis which indicated that TACE + external-beam radiation therapy (EBRT) and drug-eluting beads (DEB) were better than TACE at controllingPD. TACE + EBRT demonstrated their advantages compared to TARE-90Y.However, network meta-analysis comparison showed no significant difference between the corresponding eight treatments with respect to CR, PR, SD and ORR. Moreover, the SUCRA suggested that TACE+EBRT were better than other treatments at treating unresectableHCC.Based on the present results of this network meta-analysis, TACE + EBRT was more effective than the other seven minimally invasive surgeries and therefore it is considered as the optimal treatment for HCC.

Keywords: network meta-analysis; transcatheter arterial chemoembolization; unresectable hepatocellular carcinoma.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Literature selection flow chart
Figure 2
Figure 2. Forest plot of CRbyusingthe pair-wise meta-analysis
Figure 3
Figure 3. Forest plot of PRby usingthe pair-wise meta-analysis
Figure 4
Figure 4. Forest plot of SDby using the pair-wise meta-analysis
Figure 5
Figure 5. Forest plot of PDby using the pair-wise meta-analysis
Figure 6
Figure 6. Forest plot of ORRby using thepair-wise meta-analysis
See this image and copyright information in PMC

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