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Erschienen in:
21.05.2020 | Review
A Meta-analysis of TAE/TACE Versus Emergency Surgery in the Treatment of Ruptured HCC
Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 9/2020
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Objectives
To evaluate the efficacy and safety of TAE/TACE versus emergency surgery (ES) for spontaneous rupture of HCC (rHCC).
Methods
Eight databases (Web of Science, Pubmed, Embase, Cochrane Library, ClinicalTrial.gov, Wanfang, CNKI and VIP) were searched to obtain all related literature from the inception dates to October 2019. Subgroup analyses based on the kind of study design and kind of embolization were conducted.
Results
Twenty-one studies comparing TAE/TACE with ES were eligible. A total of 974 rHCC participants (485 participants treated with TACE/TAE and 489 participants treated with ES) were included in the present meta-analysis. TAE/TACE group was associated with lower risk of complications (OR = 0.36; 95% CI, 0.22–0.57; P < 0.0001) and in-hospital mortality (OR = 0.52; 95% CI, 0.29–0.94; P = 0.03) compared with ES group. In addition, no significant difference in successful hemostasis (OR = 1.67; 95% CI, 0.85–3.28; P = 0.13) and 1-year survival (OR = 1.08; 95% CI, 0.79–1.48; P = 0.64) between TAE/TACE and ES groups was demonstrated.
Conclusions
TAE/TACE had comparable outcomes to ES in terms of successful hemostasis and 1-year survival. Meanwhile, TAE/TACE was significantly superior to ES in terms of complications and in-hospital mortality. Therefore, TAE/TACE may be recommended as a preferable treatment for rHCC.