| Objective:To evaluate the clinical characteristics and postoperative prognosis among patients with hepatitis B virus related hepatocellular carci-noma(HBV-HCC),hepatitis C virus related hepatocellular carcinoma(HCV-HCC)and non-HBV non-HCV hepatocellular carcinoma(NBNC-HCC)pa-tients.Methods:All articles were searched using Pubmed,Embase and Cochrane databases.The Newcastle-Ottawa Scale was used to evaluate the quality of the included studies.Summary measure was hazard ratio and 95%confidence interval.Chi square-based Q test and I~2 tests were used to assess the quantity of heterogeneity among these studies.In addition,publication bias was estimated with Begg’s funnel plot and Egger test plot.Based on the results,trim and fill analysis was performed to manage the publication bias.The meta-analysis was performed by Stata 12 software.Results:Twenty-four studies published between 1997 and 2017 matched the inclusion criteria were analyzed with 19625 participants.Meta-analysis showed that the 5-year overall survival were lower in HBV-HCC(HR:0.86,95%CI:0.78 to 0.95,P=0.002)and HCV-HCC groups(HR:0.87,95%CI:0.80 to 0.94,P=0.000)than that in NBNC-HCC group,whereas no difference exist between the HBV-HCC and HCV-HCC groups.Patients with HBV or HCV infection had a worse 5-year recurrence free survival when compared to patients with NBNC-HCC(respectively:HR:0.73,95%CI:0.63 to 0.85,P=0.000;HR:0.57,95%CI:0.48 to 0.68,P=0.000).In addition,the 5-year recurrence free survival was higher in HBV-HCC group than in HCV-HCC group(HR:1.36,95%CI:1.15 to 1.60,P=0.000).The observed association between serum alpha-fetoprotein(AFP)level and postoperative prognosis was inconsistent in different subgroups.In AFP≥1000ng/ml subgroup,the 5-year overall survival was higher in HBV-HCC group than in HCV-HCC group(HR:1.10,95%CI:1.06 to 1.14,P=0.00),patients with HBV or HCV infection had worse 5-year overall survival and 5-year recurrence free survival when compared to patients with NBNC-HCC.Conclusions:This findings indicated that patients with NBNC-HCC had a significantly better postoperative prognosis than those virus-related HCC patients referring to overall survival.Meanwhile,the 5-year recurrence free survival rate of HBV-HCC is higher than that of HCV-HCC.In addition,AFP level affected the prognosis of HCC patients. |
