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Transarterial (chemo)embolization for curative resection of hepatocellular carcinoma: a systematic review and meta-analyses

  • Review – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To assess the beneficial and harmful effects of transarterial embolization (TAE) or transarterial chemoembolization (TACE) for curative resection of hepatocellular carcinoma (HCC).

Methods

The authors conducted an extensive search of studies on this strategy. All randomized controlled trials comparing TACE or TAE plus operation versus operation only were considered for inclusion, regardless of blinding, language, or publication status. Results were performed with disease-free survival (DFS) and overall survival (OS) as the primary endpoint. Tumor response and adverse events were secondary endpoints.

Results

A total of 10 studies involving 909 HCC participants finally fulfilled the predefined inclusion criteria. Four trials assessed preoperative TACE versus control and six trials assessed postoperative TACE versus control. There were significant improvements for DFS [HR 0.62 (95 % CI 0.49–0.79)] and OS [HR 0.60 (0.46–0.79)] in the postoperative TACE compared with the control when the mean tumor size was bigger than 5 cm. However, preoperative TACE did not improve DFS [HR 0.92 (0.71–1.20)] and OS [HR 1.07 (0.78–1.46)] for curative resection of HCC. Substantial differences in criteria for assessing tumor response did not allow quantitative analyses. Fever (26.7–85.9 %), abdominal pain (19.3–71.2 %), and nausea/vomiting (27.4–66.3 %) were common adverse events. Relatively rare but more serious complications were also reported.

Conclusions

Postoperative TACE offers potential benefits for curative resection of HCC when the mean tumor size is bigger than 5 cm.

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Acknowledgments

The authors thank all surgeons and staff at the Department of Hepatobiliary Surgery Center, Union Hospital, Tongji Medical College.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Hepatobiliary Surgery Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China

    Xiang Cheng, Ping Sun, Qing-Gang Hu, Zi-Fang Song, Jun Xiong & Qi-Chang Zheng

Authors
  1. Xiang Cheng
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  2. Ping Sun
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  3. Qing-Gang Hu
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  4. Zi-Fang Song
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  5. Jun Xiong
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Corresponding author

Correspondence to Qi-Chang Zheng.

Additional information

Xiang Cheng and Ping Sun have contributed equally to this work.

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Supplementary material 1 (DOC 339 kb)

432_2014_1677_MOESM2_ESM.tif

Review authors judgments about each risk of bias item presented as percentages across all included studies (TIFF 2001 kb)

Review authors judgments about each risk of bias item for each included study (TIFF 2817 kb)

Forest plot of the subgroup analysis (TIFF 5758 kb)

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Cheng, X., Sun, P., Hu, QG. et al. Transarterial (chemo)embolization for curative resection of hepatocellular carcinoma: a systematic review and meta-analyses. J Cancer Res Clin Oncol 140, 1159–1170 (2014). https://doi.org/10.1007/s00432-014-1677-4

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  • DOI: https://doi.org/10.1007/s00432-014-1677-4

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