Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies
Objective: This study aims to comprehensively analyze the influence of spontaneous tumor rupture on the prognosis of hepatocellular carcinoma patients following hepatic resection.Methods: We systematically searched four online electronic databases, including PubMed, Embase, Web of Science, and Cochr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.769233/full |
| _version_ | 1798033027135176704 |
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| author | Jiaxuan Xu Jiaze Hong Yiran Wang Lingling Zhou Binbin Xu Yuexiu Si Yujing He Yizhou Chen |
| author_facet | Jiaxuan Xu Jiaze Hong Yiran Wang Lingling Zhou Binbin Xu Yuexiu Si Yujing He Yizhou Chen |
| author_sort | Jiaxuan Xu |
| collection | DOAJ |
| description | Objective: This study aims to comprehensively analyze the influence of spontaneous tumor rupture on the prognosis of hepatocellular carcinoma patients following hepatic resection.Methods: We systematically searched four online electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library, for eligible studies published from inception to March 2021. The main endpoints were overall survival (OS) and disease-free survival (DFS).Results: This meta-analysis included 21 observational articles with 57,241 cases. The results revealed that spontaneous tumor rupture was associated with worse OS (hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.33–2.05) and DFS (HR, 1.42; 95% CI, 1.12–1.80) in resectable hepatocellular carcinoma patients. This phenomenon was observed in most subgroups, which were classified by recorded survival time, age, country, alpha-fetoprotein (AFP) concentration, liver cirrhosis, and microvascular invasion. However, in subgroups of macrovascular invasion positive, spontaneous tumor rupture was not a risk factor for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) in hepatocellular carcinoma patients after hepatectomy. For macrovascular invasion negative, compared with non-ruptured hepatocellular carcinoma patients, ruptured hepatocellular carcinoma patients exhibited worse prognosis for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) following hepatectomy.Conclusions: Spontaneous tumor rupture was a prognostic risk factor for hepatocellular carcinoma patients after hepatic resection. However, in macrovascular invasion patients, spontaneous tumor rupture was not a prognostic risk factor. |
| first_indexed | 2024-04-11T20:22:34Z |
| format | Article |
| id | doaj.art-378456590b784d03bebdc4396b061d75 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T20:22:34Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-378456590b784d03bebdc4396b061d752022-12-22T04:04:46ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2021-11-01810.3389/fsurg.2021.769233769233Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational StudiesJiaxuan Xu0Jiaze Hong1Yiran Wang2Lingling Zhou3Binbin Xu4Yuexiu Si5Yujing He6Yizhou Chen7The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, ChinaThe First Clinical Medical College, Wenzhou Medical University, Wenzhou, ChinaDepartment of Nutrition, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, ChinaThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, ChinaEmergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, ChinaObjective: This study aims to comprehensively analyze the influence of spontaneous tumor rupture on the prognosis of hepatocellular carcinoma patients following hepatic resection.Methods: We systematically searched four online electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library, for eligible studies published from inception to March 2021. The main endpoints were overall survival (OS) and disease-free survival (DFS).Results: This meta-analysis included 21 observational articles with 57,241 cases. The results revealed that spontaneous tumor rupture was associated with worse OS (hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.33–2.05) and DFS (HR, 1.42; 95% CI, 1.12–1.80) in resectable hepatocellular carcinoma patients. This phenomenon was observed in most subgroups, which were classified by recorded survival time, age, country, alpha-fetoprotein (AFP) concentration, liver cirrhosis, and microvascular invasion. However, in subgroups of macrovascular invasion positive, spontaneous tumor rupture was not a risk factor for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) in hepatocellular carcinoma patients after hepatectomy. For macrovascular invasion negative, compared with non-ruptured hepatocellular carcinoma patients, ruptured hepatocellular carcinoma patients exhibited worse prognosis for OS (HR, 1.55; 95% CI, 0.99–2.42) and DFS (HR, 1.23; 95% CI, 0.91–1.65) following hepatectomy.Conclusions: Spontaneous tumor rupture was a prognostic risk factor for hepatocellular carcinoma patients after hepatic resection. However, in macrovascular invasion patients, spontaneous tumor rupture was not a prognostic risk factor.https://www.frontiersin.org/articles/10.3389/fsurg.2021.769233/fullhepatocellular carcinomaspontaneous tumor rupturehepatectomyprognosismeta-analysis |
| spellingShingle | Jiaxuan Xu Jiaze Hong Yiran Wang Lingling Zhou Binbin Xu Yuexiu Si Yujing He Yizhou Chen Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies Frontiers in Surgery hepatocellular carcinoma spontaneous tumor rupture hepatectomy prognosis meta-analysis |
| title | Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies |
| title_full | Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies |
| title_fullStr | Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies |
| title_full_unstemmed | Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies |
| title_short | Prognostic Influence of Spontaneous Tumor Rupture in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis of Observational Studies |
| title_sort | prognostic influence of spontaneous tumor rupture in patients with hepatocellular carcinoma after hepatectomy a meta analysis of observational studies |
| topic | hepatocellular carcinoma spontaneous tumor rupture hepatectomy prognosis meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.769233/full |
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