Evidence map›Paper›PMID 39269544›Full record

SynthesisLangenbeck's archives of surgery2024

The role of resection in hepatocellular carcinoma BCLC stage B: A multi-institutional patient-level meta-analysis and systematic review.

Victor Lopez-Lopez, Fabian Kalt, Jian-Hong Zhong, Cristiano Guidetti, Paolo Magistri, Fabrizio Di Benedetto, Arndt Weinmann, Jens Mittler, Hauke Lang, Rohini Sharma and 22 more

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors.

Victor Lopez-Lopez *Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
Fabian Kalt *Department of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Jian-Hong ZhongDepartment of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, China.
Cristiano GuidettiHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Paolo MagistriHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Fabrizio Di BenedettoHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Arndt WeinmannDepartment of Internal Medicine I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Jens MittlerDepartment of General, Visceral and Transplant Surgery, University Medical Center, Johannes Gutenberg-University Mainz, 55131, Mainz, Germany.
Hauke LangDepartment of General, Visceral and Transplant Surgery, University Medical Center, Johannes Gutenberg-University Mainz, 55131, Mainz, Germany.
Rohini SharmaDepartment of Surgery and Cancer, Imperial College London, London, UK.
Mathew VithayathilDepartment of Surgery and Cancer, Imperial College London, London, UK.
Samir TariqDepartment of Surgery and Cancer, Imperial College London, London, UK.
Patricia Sánchez-VelázquezDivision of Hepatobliary and pancreatic Surgery, Hospital del Mar, Universitat Pompeu Fabra, IMIM, Barcelona, Spain.
Gianluca RompianesiDepartment of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Roberto Ivan TroisiDepartment of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Concepción Gómez-GavaraDepartment HPB and Transplantation Surgery, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Mar DalmauDepartment HPB and Transplantation Surgery, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Francisco Jose Sanchez-RomeroDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Camilo LlamozaDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Christoph TschuorDepartment of Surgery and Transplantation, Rigshospitalet Copenhagen University Hospital, Blegdamsvej 9 Copenhagen Ø, Copenhagen, 2100, Denmark.
Uluk DenizDepartment of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Georg LurjeDepartment of Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Peri HusenDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Sandro HügliDepartment of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
Jan Philipp JonasDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Fabian RösslerDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Philipp KronDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Michaela RamserDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Pablo RamirezDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Kuno LehmannDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.
Ricardo Robles-CamposDepartment of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain.
Dilmurodjon EshmuminovDepartment of Surgery and Transplantation, University Hospital Zurich and University of Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland. Dilmurodjon.eshmuminov@usz.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Barcelona Clinic Liver Cancer (BCLC) staging schema is widely used for hepatocellular carcinoma (HCC) treatment. In the updated recommendations, HCC BCLC stage B can become candidates for transplantation. In contrast, hepatectomy is currently not recommended.

methodsThis systematic review includes a multi-institutional meta-analysis of patient-level data. Survival, postoperative mortality, morbidity and patient selection criteria for liver resection and transplantation in BCLC stage B are explored. All clinical studies reporting HCC patients with BCLC stage B undergoing liver resection or transplantation were included.

resultsA total of 31 studies with 3163 patients were included. Patient level data was available for 580 patients from 9 studies (423 after resection and 157 after transplantation). The overall survival following resection was 50 months and recurrence-free survival was 15 months. Overall survival after transplantation was not reached and recurrence-free survival was 45 months. The major complication rate after resection was 0.11 (95%-CI, 0.0-0.17) with the 90-day mortality rate of 0.03 (95%-CI, 0.03-0.08). Child-Pugh A (93%), minor resection (60%), alpha protein level less than 400 (64%) were common in resected patients. Resected patients were mostly outside the Milan criteria (99%) with mean tumour number of 2.9. Studies reporting liver transplantation in BCLC stage B were scarce.

conclusionLiver resection can be performed safely in selected patients with HCC BCLC stage B, particularly if patients present with preserved liver function. No conclusion can done on liver transplantation due to scarcity of reported studies.

Indexed as

Carcinoma, HepatocellularHepatectomyLiver NeoplasmsLiver TransplantationNeoplasm StagingHumansPatient SelectionSurvival RateBCLC-BHCCLiver resectionLiver transplantation

Identifiers

PMID39269544
PMCPMC11399194

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Registered trials

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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.