Evidence map›Paper›PMID 27486202›Full record

ArticleThe oncologist2016

Is Salvage Liver Resection Necessary for Initially Unresectable Hepatocellular Carcinoma Patients Downstaged by Transarterial Chemoembolization? Ten Years of Experience.

Yingqiang Zhang, Guihua Huang, Yu Wang, Lijian Liang, Baogang Peng, Wenzhe Fan, Jianyong Yang, Yonghui Huang, Wang Yao, Jiaping Li

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 7 pooled it
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 7 syntheses or guidelines pooled it, 85 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Yingqiang ZhangDepartment of Interventional Oncology and Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Guihua HuangDepartment of Nursing, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Yu WangDepartment of Interventional Oncology and Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Lijian LiangDepartment of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Baogang PengDepartment of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Wenzhe FanDepartment of Interventional Oncology and Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Jianyong YangDepartment of Interventional Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Yonghui HuangDepartment of Interventional Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Wang YaoDepartment of Interventional Oncology and Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Jiaping LiDepartment of Interventional Oncology and Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China lijiaping3s@126.com.
Sun Yat-sen University · CNThe First Affiliated Hospital, Sun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study evaluated long-term outcomes of salvage surgery as additional therapy following downstaging of hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) in patients with initially unresectable HCC.

methodsA retrospective analysis was performed of 831 consecutive patients with unresectable HCC who underwent TACE as initial treatment between June 2004 and December 2014. Of these, 82 patients with downstaged resectable HCC were enrolled in this study: 43 received salvage surgery (S group) and the remaining 39, who refused salvage resection, were the control group (T group). The primary endpoint was overall survival (OS).

resultsThe median OS in the S and T groups was 49 and 31 months, respectively (p = .027). The 2-, 4-, and 5-year survival rates were 93%, 47%, and 26% in the S group and 74%, 18%, and 10% in the T group, respectively (p = .019). Treatment modality (hazard ratio [HR], 0.337; 95% confidential interval [CI], 0.184-0.616; p < .001) and response to TACE (complete vs. partial; HR, 3.154; 95% CI, 1.709-5.822; p < .001) were independent prognostic factors for survival. The median OS for patients in the complete response and partial response (PR) subgroups was 50 and 49 months, respectively, in the S group and 54 and 24 months, respectively, in the T group (p = .699 and p < .001, respectively). The median OS for HCC patients with macroscopic vascular invasion (MVI) was 58 and 30 months in the S and T groups, respectively (p = .024).

conclusionSalvage surgery after downstaging of unresectable HCC had a survival benefit only for patients with MVI or a PR to TACE. IMPLICATIONS FOR PRACTICE: The results of this study suggest that salvage liver resection after downstaging of unresectable hepatocellular carcinoma in patients with a complete response to transarterial chemoembolization (TACE) has a comparable long-term outcome in this good-prognosis group. Salvage liver resection may provide a better long-term outcome compared with TACE alone, but only in patients with macroscopic vascular invasion or those with a partial response to TACE.

Indexed as

Chemoembolization, TherapeuticHepatectomySalvage TherapyAdultAgedCarcinoma, HepatocellularFemaleHumansLiver NeoplasmsMaleMiddle AgedRetrospective StudiesTreatment OutcomeDownstagingHepatocellular carcinomaOverall survivalSalvage surgeryTransarterial chemoembolization

Identifiers

PMID27486202
PMCPMC5153353
OpenAlexW2487553606

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.