Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Mar 24, 2024; 15(3): 447-455
Published online Mar 24, 2024. doi: 10.5306/wjco.v15.i3.447
Transarterial chemoembolization plus stent placement for hepatocellular carcinoma with main portal vein tumor thrombosis: A meta-analysis
Wei-Fan Sui, Jian-Yun Li, Jian-Hua Fu
Wei-Fan Sui, Jian-Yun Li, Jian-Hua Fu, Department of Interventional Radiology, Zhenjiang First People's Hospital, Zhenjiang 212000, Jiangsu Province, China
Author contributions: Fu JH designed the research study; Li JY and Sui WF performed the research; Sui WF analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Fu, Doctor, Director, Department of Interventional Radiology, Zhenjiang First People’s Hospital, No. 8 Dianli Road, Zhenjiang 212000, Jiangsu Province, China. suiweifan@126.com
Received: October 29, 2023
Peer-review started: October 29, 2023
First decision: December 22, 2023
Revised: January 5, 2024
Accepted: February 4, 2024
Article in press: February 4, 2024
Published online: March 24, 2024
Processing time: 145 Days and 9.8 Hours
ARTICLE HIGHLIGHTS
Research background

Portal vein tumor thrombus (PVTT) has been recognized as an important indicator of poor prognosis for hepatocellular carcinoma (HCC) patients. HCC with main PVTT limits the effect of transarterial chemoembolization (TACE).

Research motivation

Portal vein stent placement is a safe and effective therapy for promptly restoring flow and relieving portal hypertension caused by tumor thrombus. The efficacy and safety of TACE combined with portal vein stent placement have been proved by some Chinese scholars. No meta-analysis on the clinical significance of TACE plus stent placement for HCC with main PVTT was performed.

Research objectives

This study aimed to carry out a meta-analysis to assess the clinical significance of TACE plus stent placement for HCC with main PVTT.

Research methods

We searched English and Chinese databases, assessed the quality of the included studies, analyzed the characteristic data, explored heterogeneity, and tested publication bias.

Research results

The results showed that the pressure in the main portal vein after stent placement was significantly lower than that with no stent placement. The cumulative stent patency and survival rates at 6 and 12 months were lower in the transarterial chemoembolization + stent placement group than in the transarterial chemoembolization + stent placement + brachytherapy/radiotherapy group. The survival rates of patients treated with transarterial chemoembolization + stent placement for 6 and 12 months were greater than those of patients treated with transarterial chemoembolization alone.

Research conclusions

Transarterial chemoembolization + stenting is safe. Transarterial chemoembolization + stent placement is more effective than transarterial chemoembolization alone. Transarterial chemoembolization + stent placement + brachytherapy/radiotherapy is more effective than transarterial chemoembolization + stenting.

Research perspectives

Tyrosine kinase inhibitors and immune therapies have been proved safe and effective. Adding tyrosine kinase inhibitors and immune therapies will improve the value of this study.