Clinical Research Papers:
A mixed analysis comparing nine minimally invasive surgeries for unresectable hepatocellular carcinoma patients
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Ran Tao1, Xiaodan Li2, Ruizhi Ran3, Zhihua Xiao4, Hongyue Zhang1, Hongyan Kong1, Qiqin Song1, Yu Huang1, Likui Wang5 and Jiaquan Huang1
1 Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2 Department of Infectious Diseases,The Central Hospital of Enshi Autonomous Prefecture, Enshi Clinical College of Wuhan University, Wuhan, Hubei, China
3 Department of Interal Medicine-Oncology, The Central Hospital of Enshi Autonomous Prefecture, Enshi Clinical College of Wuhan University, Wuhan, Hubei, China
4 Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, Hubei, China
5 Savaid Medical School, University of Chinese Academy of Sciences Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
Jiaquan Huang, email:
Keywords: unresectable hepatocellular carcinoma, transcatheter arterial chemoembolization, network meta-analysis
Received: June 29, 2016 Accepted: September 21, 2016 Published: September 29, 2016
Hepatocellular carcinoma (HCC) is usually managed by the transcatheter arterial chemoembolization (TACE). However, this technique has been challenged since severe complications have been observed in clinical practices. As a result, clinicians have started to seek other minimally invasive surgeries with equivalent efficacy. The corresponding surgeries were assessed by the five outcomes: complete response (CR), partial response (PR), stable disease (SD), progression disease (PD) and objective response rate (ORR). Direct meta-analysis and network meta-analysis were performed and the results were represented by odds ratios (OR), 95% confidence and credential intervals. Furthermore, the value of surface under the cumulative ranking curve (SUCRA)was calculated to provide corresponding rankings.Seventeen studies were incorporated into the network meta-analysis which indicated that TACE + external-beam radiation therapy (EBRT) and drug-eluting beads (DEB) were better than TACE at controllingPD. TACE + EBRT demonstrated their advantages compared to TARE-90Y.However, network meta-analysis comparison showed no significant difference between the corresponding eight treatments with respect to CR, PR, SD and ORR. Moreover, the SUCRA suggested that TACE+EBRT were better than other treatments at treating unresectableHCC.Based on the present results of this network meta-analysis, TACE + EBRT was more effective than the other seven minimally invasive surgeries and therefore it is considered as the optimal treatment for HCC.
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