To compare salvage liver transplantation with othotopic liver transplantation for patients with hepatocellular carcinoma: a Meta-analysis

Abstract

Objective To compare salvage liver transplantation (SLT) with othotopic liver transplantation (OLT) in treatment of hepatocellular carcinoma. Methods A systematic literature search of PubMed, Embase, Cochrane Library, CBM, CNKI and Wanfang Med Online was performed from their dates of establishment to October 2017. The results were screened, data extracted and then analyzed with Stata 14. Results 23 studies with 4 161 patients were selected, including 579 patients in the SLT group and 3 582 patients in the OLT group. Compared with OLT, SLT was associated with a longer operative time (SMD=0.56, 95%CI: 0.29~0.83), higher intraoperative blood loss (SMD=1.56, 95%CI: 0.63~2.49), an increased risk of postoperative bleeding (OR=1.84, 95%CI: 1.08~3.14), a poorer overal survival rate (HR=1.29; 95%CI: 1.11~1.49) and disease free survival rate (HR=1.88; 95%CI: 1.26~2.81). The differences were all significant (all P 0.05). Conclusions OLT is a better treatment strategy for patients with transplantable hepatocellular carcinoma (HCC) compared with SLT. However, severe organ limitation, and feasibility and safety of surgery make SLT a better option for patients with HCC recurrence after liver resection. Key words: Liver transplantation; Salvage therapy; Liver neoplasms; Meta-analysis