Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses
BackgroundHCC is a major global health concern, necessitating effective treatment strategies. This study conducts a meta-analysis of meta-analyses comparing liver resection (LR) and liver transplantation (LT) for HCC.MethodsThe systematic review included meta-analyses comparing liver resection vs. l...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1366607/full |
| _version_ | 1797258771169280000 |
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| author | Alessandro Martinino Angela Bucaro Francesca Cardella Ishaan Wazir Francesco Frongillo Francesco Ardito Francesco Giovinazzo |
| author_facet | Alessandro Martinino Angela Bucaro Francesca Cardella Ishaan Wazir Francesco Frongillo Francesco Ardito Francesco Giovinazzo |
| author_sort | Alessandro Martinino |
| collection | DOAJ |
| description | BackgroundHCC is a major global health concern, necessitating effective treatment strategies. This study conducts a meta-analysis of meta-analyses comparing liver resection (LR) and liver transplantation (LT) for HCC.MethodsThe systematic review included meta-analyses comparing liver resection vs. liver transplantation in HCC, following PRISMA guidelines. Primary outcomes included 5-year overall survival (OS) and disease-free survival (DFS). AMSTAR-2 assessed study quality. Citation matrix and hierarchical clustering validated the consistency of the included studies.ResultsA search identified 10 meta-analyses for inclusion. The median Pearson correlation coefficient for citations was 0.59 (IQR 0.41-0.65). LT showed better 5-year survival and disease-free survival in all HCC (OR): 0.79; 95% CI: 0.67-0.93, I^2:57% and OR: 0.44; 95% CI: 0.25-0.75, I^2:96%). Five-year survival in early HCC and ITT was 0.63 (95% CI: 0.50-0.78, I^2:0%) and 0.60 (95% CI: 0.39-0.92, I^2:0%). Salvage LT vs. Primary LT did not differ between 5-year survival and disease-free survival (OR: 0.62; 95% CI: 0.33-1.15, I^2:0% and 0.93; 95% CI: 0.82-1.04, I^2:0%).ConclusionOverall, the study underscores the superior survival outcomes associated with LT over LR in HCC treatment, supported by comprehensive meta-analysis and clustering analysis. There was no difference in survival or recurrence rate between salvage LT and primary LT. Therefore, considering the organ shortage, HCC can be resected and transplanted in case of recurrence. |
| first_indexed | 2024-04-24T22:58:49Z |
| format | Article |
| id | doaj.art-fbfc09e4019746e1b123732fca6709ba |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-24T22:58:49Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fbfc09e4019746e1b123732fca6709ba2024-03-18T04:29:31ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-03-011410.3389/fonc.2024.13666071366607Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analysesAlessandro Martinino0Angela Bucaro1Francesca Cardella2Ishaan Wazir3Francesco Frongillo4Francesco Ardito5Francesco Giovinazzo6Department of Surgery, Duke University, Durham, NC, United StatesGeneral Surgery and Liver Transplant Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalySurgical Oncology of Gastrointestinal Tract Unit, Vanvitelli University, Naples, ItalyVardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, IndiaGeneral Surgery and Liver Transplant Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyHepatobilairy and General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyGeneral Surgery and Liver Transplant Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyBackgroundHCC is a major global health concern, necessitating effective treatment strategies. This study conducts a meta-analysis of meta-analyses comparing liver resection (LR) and liver transplantation (LT) for HCC.MethodsThe systematic review included meta-analyses comparing liver resection vs. liver transplantation in HCC, following PRISMA guidelines. Primary outcomes included 5-year overall survival (OS) and disease-free survival (DFS). AMSTAR-2 assessed study quality. Citation matrix and hierarchical clustering validated the consistency of the included studies.ResultsA search identified 10 meta-analyses for inclusion. The median Pearson correlation coefficient for citations was 0.59 (IQR 0.41-0.65). LT showed better 5-year survival and disease-free survival in all HCC (OR): 0.79; 95% CI: 0.67-0.93, I^2:57% and OR: 0.44; 95% CI: 0.25-0.75, I^2:96%). Five-year survival in early HCC and ITT was 0.63 (95% CI: 0.50-0.78, I^2:0%) and 0.60 (95% CI: 0.39-0.92, I^2:0%). Salvage LT vs. Primary LT did not differ between 5-year survival and disease-free survival (OR: 0.62; 95% CI: 0.33-1.15, I^2:0% and 0.93; 95% CI: 0.82-1.04, I^2:0%).ConclusionOverall, the study underscores the superior survival outcomes associated with LT over LR in HCC treatment, supported by comprehensive meta-analysis and clustering analysis. There was no difference in survival or recurrence rate between salvage LT and primary LT. Therefore, considering the organ shortage, HCC can be resected and transplanted in case of recurrence.https://www.frontiersin.org/articles/10.3389/fonc.2024.1366607/fullliver transplantationliver resectionhepatocellular carcinomasurvivalmeta-analysis |
| spellingShingle | Alessandro Martinino Angela Bucaro Francesca Cardella Ishaan Wazir Francesco Frongillo Francesco Ardito Francesco Giovinazzo Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses Frontiers in Oncology liver transplantation liver resection hepatocellular carcinoma survival meta-analysis |
| title | Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses |
| title_full | Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses |
| title_fullStr | Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses |
| title_full_unstemmed | Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses |
| title_short | Liver transplantation vs liver resection in HCC: promoting extensive collaborative research through a survival meta-analysis of meta-analyses |
| title_sort | liver transplantation vs liver resection in hcc promoting extensive collaborative research through a survival meta analysis of meta analyses |
| topic | liver transplantation liver resection hepatocellular carcinoma survival meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1366607/full |
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