Abstract
Context: Transarterial embolization/chemoembolization (TAE/TACE) has been shown to be effective against ruptured hepatocellular carcinoma (HCC). However, the early clinical mortality remains unpredictable. Objectives: To conduct a comprehensive quantitative evaluation of early mortality after emergency TAE/TACE for spontaneous HCC rupture and to perform an overall analysis of risk factors to gather more representative data. Methods: The PubMed/Medline, Web of Science, and Embase databases were searched, and relevant studies were retrieved using the corresponding English keywords. Next, the literature was screened according to the inclusion and exclusion criteria. Finally, Stata version 15.1 and R Project 4.1.2 were used for meta-analysis. Results: A total of 24 studies (n = 1,083) were included in this meta-analysis. The combined 30-day mortality following emergency TAE/TACE for spontaneous HCC rupture was 28.8% (95% confidence interval [CI]: 23.4 - 34.4%). After correcting for publication bias, the combined 30-day mortality rate was estimated at 28.1% (95% CI: 22.7 - 33.6%). The results of subgroup and regression analyses also revealed that preoperative liver cirrhosis and bilobar tumor distribution were significantly associated with increased 30-day mortality following TAE/TACE (P < 0.05 for all). After re-stratification of studies by publication time, it was found that the 30-day mortality after TAE/TACE treatment for spontaneous HCC rupture has decreased significantly in the past two years (P = 0.0074); the corresponding value was 19.1% (95% CI: 14.3 - 24.3%) during 2020 - 2021 and 31.6% (95% CI: 26.4 - 36.9%) during 2001 - 2010. Three independent factors, including liver cirrhosis, bilobar tumor distribution, and period of time, may be potential factors for heterogeneity. Conclusion: In recent years, although early mortality has significantly reduced after emergency TAE/TACE for spontaneous HCC rupture, it is still not negligible. Before TAE/TACE, it is necessary for clinicians to predict the adverse outcomes, as well as the risk factors and disease-related factors, and to formulate appropriate intervention measures.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
