Meta-analysis of long-term survival in patients with spontaneous rupture of hepatocellular carcinoma after hepatectomy

Abstract

Abstract: Objective: Spontaneous rupture of hepatocellular carcinoma (HCC) is associated with high mortality rates, and hepatic resection can provide better outcomes than other available treatments. However, whether HCC rupture affects tumor recurrence and patient survival remains controversial.
Method: From inception to January 14, 2020. The electronic databases of PubMed, OVID, Web of Science, Embase, and the Cochrane Library were searched from the date of database inception until January 14, 2020, and studies reporting survival outcomes with comparison between rupture HCC (rHCC) and non-rupture HCC (nrHCC) were included. The reported data were statistically summarized using Review Manager V5.3.
Result: A total of 3 144 patients from nine cohort studies were included. The overall survival (OS) and disease-free survival (DFS) were lower in the rHCC group than in the nrHCC group. The subgroup analysis of high-quality propensity-matched analyses to investigate the true impact of rupture on DFS and OS between the rHCC and nrHCC groups with no heterogeneity. The 1, 3, and 5 years hazard ratios (HR) of OS were 5.30 (95% confidence interval [95%CI]: 3.42-8.22), 5.76 (95%CI: 4.24-7.81), and 4.20 (95%CI: 3.20-5.51), respectively. The HR of 1, 3 and 5 years DFS were 3.68 (95%CI: 2.67- 5.07), 3.87 (95%CI: 2.99- 5.02) and 3.72 (95%CI: 2.93- 4.72), respectively.
Conclusion: The present Meta-analysis demonstrated that the DSF and OS were significantly lower in the rHCC group than in the nrHCC group and that spontaneous HCC rupture was a predictor of poor survival outcomes.

Key words: Hepatocellular carcinoma, Hepatectomy, Rupture spontaneous, Survival, Meta-analysis

Zhang Jing, Huang Xiaozhun, Huang Zhangkan, Xu Lin, Yin Xin, Bi Xinyu, Che Xu, Ni Yong. Meta-analysis of long-term survival in patients with spontaneous rupture of hepatocellular carcinoma after hepatectomy[J]. Electronic Journal of Liver Tumor, 2024, 11(4): 42-49.

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