The Meta-analysis Of The Prognosis Of Hepatocellular Carcinomapatients With Portal Vein Tumor Thrombus Treatment With Transcatheter Arterial Chemoembolization

Objective：Application of Meta-analysis to evaluate the patients ofhepatocellular carcinoma (Hepatocellular Carcinoma, HCC) with portalvein tumor thrombosis (Portal Vein Tumor Thrombosis,PVTT) with theclinical efficacy of TACE, to guide the clinical work.Methods：Two reviewers searched PubMed(1966to Jan.2014),EMbase(1974to Jan.2014)， CBM(1979to Jan.2014), CNKI(1979toJan.2014) and VIP (1989to Jan.2014) by computer. Two authors identifiedstudies which of hepatocellular carcinoma patients with portal vein tumorthrombus underwent transcatheter arterial chemoembolization.Two authorsinternalized randomized controlled trial(Randomized ControlledTrial,RCT)、controlled clinical trial(Controlled Clinical Trial,CCT) andcohort study in Chinese and English which met the inclusion criterion,extracted data and evaluated the literatures quality. We integrated andanalyze the extracted data by software Review Manager5.2.Results： Retrieved9literatures met the inclusion criteria, involved 1068patients, of which6is RCT,3is CCT.9literatures for hepatocellularcarcinoma with portal vein tumor thrombus underwent TACE comparedwith the conservative treatment.The results showed that: compared to theTACE treatment and conservative treatment:TACE can significantlyimprove the hepatocellular carcinoma with portal vein tumor thrombus inthe half year survival rate of [OR=4.92,95%CI (2.73,8.86)](P<0.0001),1year survival rate of [OR=10.73,95%CI (3.12,36.95)](P<0.0001),2yearsurvival rate of [OR=25.45,95%CI (8.00,80.99)](P<0.0001).For thedifferent type of PVTT,, the type I gets better benefit from TACE than typeII and III, type II is better than type III,the effect of type IV is the worst.Conclusion： Hepatocellular carcinoma with portal vein tumorthrombus in patients with transcatheter arterial chemoembolization forconservative treatment can significantly increase the survival rate ofpatients.For the different type of PVTT,, the type I gets better benefit fromTACE than type II and III, type II is better than type III,the effect of typeIV is the worst.