Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Objective Here, we aimed to compare early hepatectomy (EH) with delayed hepatectomy (DH) as a treatment for spontaneously ruptured hepatocellular carcinoma (HCC). Methods Several databases were systematically searched for eligible studies that compared DH with EH for spontaneously ruptured HCC treat...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-11-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2020.1792009 |
| _version_ | 1797684523592318976 |
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| author | Ying-jun Zheng Dong-lun Li De Luo Xin-pei Chen Bin Zhang Cheng Fang Yu Gan Bo Li Song Su |
| author_facet | Ying-jun Zheng Dong-lun Li De Luo Xin-pei Chen Bin Zhang Cheng Fang Yu Gan Bo Li Song Su |
| author_sort | Ying-jun Zheng |
| collection | DOAJ |
| description | Objective Here, we aimed to compare early hepatectomy (EH) with delayed hepatectomy (DH) as a treatment for spontaneously ruptured hepatocellular carcinoma (HCC). Methods Several databases were systematically searched for eligible studies that compared DH with EH for spontaneously ruptured HCC treatment. Studies that met the inclusion criteria were reviewed systematically, and the reported data were aggregated statistically, using the RevMan v5.3 software. Results Seven studies were included, with a total of 385 patients, comprising of 224 EH cases and 161 DH cases. Compared with the EH group, incidence of intraoperative bleeding [mean difference (MD), 353.93; 95% CI, 230.04-447.83; P < 0.00001], volume of intraoperative blood transfusion (MD, 420.61; 95% CI, 354.40-486.81, P < 0.00001), and 30-day mortality rate (OR, 14.94; 95% CI, 1.76-126.66; P = 0.01) were significantly lower in the DH group. Furthermore, the 1-, 2-, and 3-year survival rates were significantly higher in the DH group [1-year：hazard ratio (HR), 1.76; 95% CI, 1.06-2.94; P = 0.03; 2-year：HR, 1.52; 95% CI, 1.02-2.25; P = 0.04; 3-year: HR, 1.53; 95% CI, 1.06-2.21; P = 0.02]. There was no difference between the groups in the 5-year survival rate (HR, 1.40; 95% CI, 0.92-2.11; P = 0.11). Conclusion For resectable spontaneously ruptured HCC, DH could reduce intraoperative bleeding, intraoperative blood transfusion volume, and 30-day mortality rate and increase the 1-, 2-, and 3-year survival rates, endowing the patients with greater short- and long-term benefits during and following the surgery. |
| first_indexed | 2024-03-12T00:30:54Z |
| format | Article |
| id | doaj.art-1b6ca092cf854b60bfe1ff864c76fe7b |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:30:54Z |
| publishDate | 2021-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-1b6ca092cf854b60bfe1ff864c76fe7b2023-09-15T10:12:29ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-11-0134111214122210.1080/08941939.2020.17920091792009Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-AnalysisYing-jun Zheng0Dong-lun Li1De Luo2Xin-pei Chen3Bin Zhang4Cheng Fang5Yu Gan6Bo Li7Song Su8Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityGeneral Surgery Department, Jingyan County people’s HospitalDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityDepartment of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical UniversityObjective Here, we aimed to compare early hepatectomy (EH) with delayed hepatectomy (DH) as a treatment for spontaneously ruptured hepatocellular carcinoma (HCC). Methods Several databases were systematically searched for eligible studies that compared DH with EH for spontaneously ruptured HCC treatment. Studies that met the inclusion criteria were reviewed systematically, and the reported data were aggregated statistically, using the RevMan v5.3 software. Results Seven studies were included, with a total of 385 patients, comprising of 224 EH cases and 161 DH cases. Compared with the EH group, incidence of intraoperative bleeding [mean difference (MD), 353.93; 95% CI, 230.04-447.83; P < 0.00001], volume of intraoperative blood transfusion (MD, 420.61; 95% CI, 354.40-486.81, P < 0.00001), and 30-day mortality rate (OR, 14.94; 95% CI, 1.76-126.66; P = 0.01) were significantly lower in the DH group. Furthermore, the 1-, 2-, and 3-year survival rates were significantly higher in the DH group [1-year：hazard ratio (HR), 1.76; 95% CI, 1.06-2.94; P = 0.03; 2-year：HR, 1.52; 95% CI, 1.02-2.25; P = 0.04; 3-year: HR, 1.53; 95% CI, 1.06-2.21; P = 0.02]. There was no difference between the groups in the 5-year survival rate (HR, 1.40; 95% CI, 0.92-2.11; P = 0.11). Conclusion For resectable spontaneously ruptured HCC, DH could reduce intraoperative bleeding, intraoperative blood transfusion volume, and 30-day mortality rate and increase the 1-, 2-, and 3-year survival rates, endowing the patients with greater short- and long-term benefits during and following the surgery.http://dx.doi.org/10.1080/08941939.2020.1792009hepatocellular carcinomaspontaneously ruptured tumorearly hepatectomydelayed hepatectomymeta-analysis |
| spellingShingle | Ying-jun Zheng Dong-lun Li De Luo Xin-pei Chen Bin Zhang Cheng Fang Yu Gan Bo Li Song Su Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis Journal of Investigative Surgery h epatocellular carcinoma spontaneously ruptured tumor early hepatectomy delayed hepatectomy meta-analysis |
| title | Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis |
| title_full | Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis |
| title_fullStr | Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis |
| title_short | Early versus Delayed Hepatectomy for Spontaneously Ruptured Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis |
| title_sort | early versus delayed hepatectomy for spontaneously ruptured hepatocellular carcinoma a systematic review and meta analysis |
| topic | h epatocellular carcinoma spontaneously ruptured tumor early hepatectomy delayed hepatectomy meta-analysis |
| url | http://dx.doi.org/10.1080/08941939.2020.1792009 |
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