Evidence map›Paper›PMID 40597024›Full record

SynthesisBMC cancer2025

Balloon-occluded versus conventional transarterial chemoembolization for the treatment of early to intermediate stage hepatocellular carcinoma: a meta-analysis and trial sequential analysis.

Jiaxi Liu, Weiwei Wang, Huan Zhai, Yanan Ma, Qiwen You, Haibo Shao

Abstract readMeta-AnalysisComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

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

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
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

6 authors.

Jiaxi Liu *Department of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
Weiwei Wang *Department of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
Huan ZhaiDepartment of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
Yanan MaDepartment of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, 110100, People's Republic of China.
Qiwen YouDepartment of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
Haibo ShaoDepartment of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China. hbshao@cmu.edu.cn.

Funding

Liaoning Medical-Engineering Cross Fund 2022-YGJC-53National Natural Science Foundation of China No.82072037, 82372070, 82111530100
6 · The paper itself

Abstract

backgroundWe performed a meta-analysis and trial sequential analysis (TSA) to compare the therapeutic efficacy and adverse events (AEs) of balloon-occluded transarterial chemoembolization (B-TACE) with conventional transarterial chemoembolization (cTACE) in treating early-to-intermediate-stage hepatocellular carcinoma (HCC).

methodsWe systematically searched PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases for studies comparing B-TACE and cTACE in the treatment of HCC. The outcomes included the complete response (CR) rate, objective response rate (ORR), lipiodol consumption, and adverse events (AEs). Depending on the heterogeneity assessment, either a fixed-effects or random-effects model was utilized, followed by a meta-analysis using Review Manager 5.3. Additionally, a TSA was conducted to assess the adequacy of the sample size.

resultsFive studies including a total of 1166 patients were analyzed. This meta-analysis revealed that compared with cTACE, B-TACE significantly improved the CR rate (risk ratio [RR] = 1.21, 95% confidence interval [CI] 1.04-1.42, p = 0.02) and the ORR (RR = 1.23, 95% CI 1.09-1.38, p = 0.0006). These findings were validated using TSA, which did not require a larger information size. The TSA results indicated that B-TACE consumed more lipiodol than cTACE, potentially leading to more satisfactory embolization efficacy. In terms of AEs, only post-embolization syndrome was found to occur more frequently in patients treated with B-TACE than in those treated with cTACE (RR = 1.30, 95% CI 1.01-1.68, p = 0.04). However, the TSA suggested that additional cases are necessary to confirm this difference.

conclusionsB-TACE consumed more lipiodol and demonstrated superior effects on the CR rate and ORR compared to cTACE in the treatment of HCC. Importantly, this improvement in efficacy did not correspond to a significant increase in AEs. Based on these findings, it is recommended that well-designed, large-scale randomized controlled trials be conducted to further validate and expand upon these results.

trial registrationThis study was registered in the international prospective register of systematic reviews PROSPERO (registration No: CRD42023489055).

Indexed as

Balloon OcclusionCarcinoma, HepatocellularChemoembolization, TherapeuticLiver NeoplasmsEthiodized OilHumansNeoplasm StagingTreatment OutcomeEthiodized OilBalloon-occluded transarterial chemoembolizationConventional transarterial chemoembolizationHepatocellular carcinomaMeta-analysisTrial sequential analysis

Identifiers

PMID40597024
PMCPMC12210613

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.