肝移植术与肝切除术治疗原发性肝癌的meta分析

目的通过meta分析对肝移植术(OLT)和肝切除术(RT)治疗原发肝细胞癌(HCC)的疗效进行综合比较。方法通过计算机检索PubMed、EMBASE、Ovid、ScineceDirect、Springerlink、EBSCO、CBM、CNKI数据库、万方、维普,及手工检索国内1990～2010年发表的有关于肝移植和肝切除治疗肝细胞癌的相关文献,选择RevMan5.0软件、用固定效应模型进行Meta分析。结果按照入选标准,有9项临床试验纳入。Meta分析结果显示,肝移植组和肝切除组患者术后1年生存率相似(OR=1.26,95%CI为0.93～1.17,P=0.13),肝移植组术后3年生存率高于肝切除组(OR=1.68,95%CI为1.31～2.17,P<0.01),肝移植组术后5年生存率高于肝切除组(OR=2.17,95%CI为1.63～2.89,P<0.01),肝移植组术后5年无瘤生存率高于肝切除组(OR=5.07,95%CI为3.27～7.86,P<0.01),肝移植组术后复发率低于肝切除组(OR=0.10,95%CI为0.06～0.14,P<0.01)。结论肝移植术和肝切除术均是治疗肝细胞癌的有效手术方法,但肝移植术预后较肝切除术有优势。

Liver transplantation versus resection for treatment of hepatocellular carcinoma: A meta-analysis

Objective To systematically evaluate the efficacy of liver transplantation(OLT) and resection(RT) for hepatocellular carcinoma(HCC) with meta-analysis.Methods The literature on the therapeutic effect of OLT and RT on HCC was retrieved combined with manual retrieval from Pubmed,EMBASE,Ovid,ScienceDirect,Springerlink,EBSCO,CBM,China National Knowledge Infrastructure(CNKI),Wanfang Database,and Weipu Database published between 1990 and 2010 in China.RevMan 5.0 software was used for data analysis.Results According to the selection criteria,9 clinical trials were selected finally.The combined results of meta-analysis with fixed effect model showed that the 1-year survival rate was similar(OR=1.26,95% CI 0.93-1.17,P=0.13);3-year survival rate in HCC patients was higher with OLT than with RT(OR=1.68,95% CI 1.31-2.17,P<0.01);5-year survival rate was higher with OLT than with RT(OR=2.17,95% CI 1.63-2.89,P<0.01);5-year survival disease-free rate was higher with OLT than with RT(OR=5.07,95% CI 3.27-7.86,P<0.01),and the recurrence rate of HCC was lower with OLT than with RT(OR=0.10,95% CI 0.06-0.14,P<0.01).Conclusion OLT and RT are both effective surgical methods for treating HCC,but OLT leads to a better prognosis in HCC than RT.