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Meta-Analysis
. 2022 Jul;6(7):1813-1826.
doi: 10.1002/hep4.1923. Epub 2022 Mar 2.

Global and regional long-term survival following resection for HCC in the recent decade: A meta-analysis of 110 studies

Rosyli F Reveron-Thornton  1 , Margaret L P Teng  2 , Eunice Yewon Lee  3 , Andrew Tran  4 , Sean Vajanaphanich  5 , Eunice X Tan  2 , Sanjna N Nerurkar  6 , Rui Xin Ng  2 , Readon Teh  2 , Debi Prasad Tripathy  7 , Takanori Ito  8 , Taku Tanaka  8 , Nozomi Miyake  9 , Biyao Zou  3   10 , Connie Wong  11 , Hidenori Toyoda  12 , Carlos O Esquivel  13 , C Andrew Bonham  13 , Mindie H Nguyen  3   10 , Daniel Q Huang  2   14
Affiliations
Meta-Analysis

Global and regional long-term survival following resection for HCC in the recent decade: A meta-analysis of 110 studies

Rosyli F Reveron-Thornton et al. Hepatol Commun. 2022 Jul.

Abstract

Surgical resection for HCC remains a major curative treatment option, but it is unclear whether there are differences in outcomes by region and whether outcomes have improved over time. We aimed to estimate pooled overall survival (OS), recurrence-free survival (RFS), and complication rates in patients with hepatocellular carcinoma (HCC) following curative surgical resection and to compare outcomes by region and by time period. In this systematic review and meta-analysis, we searched Pubmed, Embase, and Cochrane databases from inception to May 15, 2020. We selected studies reporting OS, RFS, and complications in adult patients with HCC undergoing curative surgical resection. Two authors independently searched the literature and extracted the data. We screened 6983 articles and included 110 eligible studies with 82,392 patients, with study periods spanning from 1980-2017. The global pooled 1-year and 5-year survival rates were 88.9% (95% confidence interval [CI] 87.1-90.4) and 56.2% (95% CI 52.8-59.6) for OS and 71.1% (95% CI 67.6-74.3) and 35.2% (95% CI 32.5-38.0) for RFS, respectively. Five-year OS was higher in Asia (57.03%) than in other regions (Europe 48.3%; North America 48.0%; and South America 49.5%); p = 0.002. Five-year RFS was higher in patients with hepatitis B virus versus patients with hepatitis C virus (34.8% vs. 24.1%; p = 0.02). There was no significant improvement in 5-year OS and RFS over time. The pooled rate for complications was 27.6% (95% CI 23.4-32.3), with 9.7% (95% CI 6.3-14.7) classified as major. One-year OS after surgical resection for HCC is excellent (~90%). However, 5-year OS (~55%) and RFS (~35%) are still poor, suggesting that long-term care is suboptimal. Greater efforts are required to improve survival through enhanced surveillance and preventing recurrence through antiviral therapy.

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Conflict of interest statement

M.H.N. received grant support from Glycotest, Gilead, B. K. Kee Foundation, and National Cancer Institute, and served as a consultant/advisory board for Intercept, Laboratory of Advanced Medicine, Bayer, Eisai, Gilead, Novartis, Janssen, Eli Lilly, and Exact Sciences. D.Q.H. received grant support from the National Medical Research Council (Singapore) Research Training Fellowship and Exxon‐Mobil NUS Research Scholarship for Clinicians, and served on an advisory board for Eisai. T.T. received a Grant‐in‐Aid for Young Scientists from the Japan Society for the Promotion of Science. H.T. has received a speaker’s fee from AbbVie, MSD, Gilead, Bayer, and Eisai.

Figures

FIGURE 1
FIGURE 1
Flow chart of literature search and study selection
FIGURE 2
FIGURE 2
Country‐level 5‐year overall and recurrence free survival (RFS) after curative resection for hepatocellular carcinoma (HCC)
See this image and copyright information in PMC

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