Survival and safety outcomes of hepatectomy versus ablation in hepatocellular carcinoma within Milan criteria and clinically significant portal hypertension: a systematic review and meta-analysis.
메타분석
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
972 patients were included.
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
Ablation was associated with lower overall complication risks, particularly a 69% reduction in ascites (OR = 0.31). [CONCLUSIONS] This study suggests that the long-term survival rates of hepatectomy and ablation are comparable, but hepatectomy shows better recurrence control, especially in HBV-related cases.
[BACKGROUND] The applicability and safety of hepatectomy in hepatocellular carcinoma (HCC) patients with clinically significant portal hypertension (CSPH) remain controversial.
- p-value P < 0.001
- p-value P = 0.008
- 95% CI 0.76-1.61
- OR 0.31
- HR 1.10
- 연구 설계 Meta-analysis
APA
Wen YH, Yang YM, et al. (2026). Survival and safety outcomes of hepatectomy versus ablation in hepatocellular carcinoma within Milan criteria and clinically significant portal hypertension: a systematic review and meta-analysis.. International journal of surgery (London, England), 112(4), 10642-53. https://doi.org/10.1097/JS9.0000000000004752
MLA
Wen YH, et al.. "Survival and safety outcomes of hepatectomy versus ablation in hepatocellular carcinoma within Milan criteria and clinically significant portal hypertension: a systematic review and meta-analysis.." International journal of surgery (London, England), vol. 112, no. 4, 2026, pp. 10642-53.
PMID
41570297 ↗
Abstract 한글 요약
[BACKGROUND] The applicability and safety of hepatectomy in hepatocellular carcinoma (HCC) patients with clinically significant portal hypertension (CSPH) remain controversial. This study aimed to compare the safety and long-term outcomes of hepatectomy versus ablation in HCC patients within the Milan criteria and concomitant CSPH.
[MATERIALS AND METHODS] Following the PRISMA 2020 guidelines, a systematic literature search was conducted across PubMed, Cochrane, and other databases from inception to 20 April 2025. AI-assisted screening was performed using AS Review. Meta-analysis was conducted using R software (v4.4.1). Fixed-effect or random-effect models were used to calculate the comprehensive effect magnitude for overall survival (OS) and recurrence-free survival (RFS). Sparse Bayesian meta-analysis was applied to postoperative complications. Individual patient data (IPD) reconstruction validated survival outcomes.
[RESULTS] Seven studies (1 RCT, 6 retrospective) involving 972 patients were included. Pooled analysis showed no significant difference in OS between ablation and hepatectomy (HR = 1.10, 95% CI: 0.76-1.61, P = 0.644), but hepatectomy significantly improved RFS (HR = 2.05, 95% CI: 1.54-2.71, P < 0.001). Adjusted analyses revealed nonsignificant RFS differences (HR = 1.63, 95% CI: 0.85-3.13, P = 0.151). Subgroup analysis demonstrated superior RFS with hepatectomy versus radiofrequency ablation (HR = 2.01, 95% CI: 1.18-3.42, P = 0.008), though OS remained comparable. Notably, hepatectomy conferred dual benefits in hepatitis B virus (HBV)-related HCC for both OS (HR = 1.45, P = 0.016) and RFS (HR = 1.90, P = 0.006). IPD reconstruction further supported hepatectomy's RFS advantage (HR = 1.81, P < 0.001). Ablation was associated with lower overall complication risks, particularly a 69% reduction in ascites (OR = 0.31).
[CONCLUSIONS] This study suggests that the long-term survival rates of hepatectomy and ablation are comparable, but hepatectomy shows better recurrence control, especially in HBV-related cases.
[MATERIALS AND METHODS] Following the PRISMA 2020 guidelines, a systematic literature search was conducted across PubMed, Cochrane, and other databases from inception to 20 April 2025. AI-assisted screening was performed using AS Review. Meta-analysis was conducted using R software (v4.4.1). Fixed-effect or random-effect models were used to calculate the comprehensive effect magnitude for overall survival (OS) and recurrence-free survival (RFS). Sparse Bayesian meta-analysis was applied to postoperative complications. Individual patient data (IPD) reconstruction validated survival outcomes.
[RESULTS] Seven studies (1 RCT, 6 retrospective) involving 972 patients were included. Pooled analysis showed no significant difference in OS between ablation and hepatectomy (HR = 1.10, 95% CI: 0.76-1.61, P = 0.644), but hepatectomy significantly improved RFS (HR = 2.05, 95% CI: 1.54-2.71, P < 0.001). Adjusted analyses revealed nonsignificant RFS differences (HR = 1.63, 95% CI: 0.85-3.13, P = 0.151). Subgroup analysis demonstrated superior RFS with hepatectomy versus radiofrequency ablation (HR = 2.01, 95% CI: 1.18-3.42, P = 0.008), though OS remained comparable. Notably, hepatectomy conferred dual benefits in hepatitis B virus (HBV)-related HCC for both OS (HR = 1.45, P = 0.016) and RFS (HR = 1.90, P = 0.006). IPD reconstruction further supported hepatectomy's RFS advantage (HR = 1.81, P < 0.001). Ablation was associated with lower overall complication risks, particularly a 69% reduction in ascites (OR = 0.31).
[CONCLUSIONS] This study suggests that the long-term survival rates of hepatectomy and ablation are comparable, but hepatectomy shows better recurrence control, especially in HBV-related cases.
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
🏷️ 같은 키워드 · 무료전문 — 이 논문 MeSH/keyword 기반
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