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A Meta-analysis of TAE/TACE Versus Emergency Surgery in the Treatment of Ruptured HCC

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  • Interventional Oncology
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Abstract

Objectives

To evaluate the efficacy and safety of TAE/TACE versus emergency surgery (ES) for spontaneous rupture of HCC (rHCC).

Methods

Eight databases (Web of Science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, Wanfang, CNKI and VIP) were searched to obtain all related literature from the inception dates to October 2019. Subgroup analyses based on the kind of study design and kind of embolization were conducted.

Results

Twenty-one studies comparing TAE/TACE with ES were eligible. A total of 974 rHCC participants (485 participants treated with TACE/TAE and 489 participants treated with ES) were included in the present meta-analysis. TAE/TACE group was associated with lower risk of complications (OR = 0.36; 95% CI, 0.22–0.57; P < 0.0001) and in-hospital mortality (OR = 0.52; 95% CI, 0.29–0.94; P = 0.03) compared with ES group. In addition, no significant difference in successful hemostasis (OR = 1.67; 95% CI, 0.85–3.28; P = 0.13) and 1-year survival (OR = 1.08; 95% CI, 0.79–1.48; P = 0.64) between TAE/TACE and ES groups was demonstrated.

Conclusions

TAE/TACE had comparable outcomes to ES in terms of successful hemostasis and 1-year survival. Meanwhile, TAE/TACE was significantly superior to ES in terms of complications and in-hospital mortality. Therefore, TAE/TACE may be recommended as a preferable treatment for rHCC.

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Correspondence to Qiang Liu or Xiangzhong Huang.

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Xu, X., Chen, C., Liu, Q. et al. A Meta-analysis of TAE/TACE Versus Emergency Surgery in the Treatment of Ruptured HCC. Cardiovasc Intervent Radiol 43, 1263–1276 (2020). https://doi.org/10.1007/s00270-020-02514-5

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