TY - JOUR AU - Ibrahim, Catrine AU - Parra, Natalia AU - Macedo, Francisco Igor AU - Yakoub, Danny PY - 2019 TI - Is hepatic resection better than transarterial chemoembolization in hepatocellular carcinoma with portal vein tumor thrombosis? JF - Journal of Gastrointestinal Oncology; Vol 10, No 6 (December 17, 2019): Journal of Gastrointestinal Oncology (Current Status of Colorectal Cancer Surgery) Y2 - 2019 KW - N2 - Background: The management of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR) and transarterial chemoembolization (TACE). Methods: Comprehensive online databases search was performed. Comparative studies measuring survival in HCC patients with PVTT undergoing HR versus TACE were included. Pooled risk ratios with corresponding 95% confidence intervals (CI) were calculated for overall survival (OS) at 1, 3, and 5 years. Study quality and heterogeneity was assessed. Results: Six studies comprising 1,320 patients were included. HR was done in 526 (39.8%) patients and TACE in 794 (60.2%) patients. Meta-analysis of all included studies showed improved OS in HR compared to TACE patients at 1-year (OR: 1.49, 95% CI: 1.16–1.92, P=0.002), 3-year (OR: 3.33, 95% CI: 1.55–7.12, P=0.002) and 5-year (OR: 3.91, 95% CI: 1.42–10.77, P=0.008). Survival benefit conferred by HR was 7–33 months. This benefit was mostly noted in tumors with PVTT types I and II and those with single lesions. Age, ECOG status, and STROBE score did not contribute to differences in survival. Conclusions: Long-term survival outcomes of HCC with PVTT are superior in patients undergoing hepatectomy compared to TACE. Further experience with randomized clinical trials may be warranted to confirm these findings. UR - https://jgo.amegroups.org/article/view/32552