SynthesisHepatology (Baltimore, Md.)2026
Hepatocellular carcinoma with macrovascular invasion: Review and survival meta-analysis of initial local therapy using minimal prognostic criteria.
Synthesis in Hepatology (Baltimore, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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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.
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Who cites it
2 citing papers in PubMed.
- A dual-transformable MgGa-MOF nanoplatform for HCC therapy via lactate metabolism blockade and immune reactivation.Journal of nanobiotechnology · 2026Article
- Liver transplantation for hepatocellular carcinoma: from patient selection and downstaging to risk stratification and post-transplant surveillance.Gastroenterology report · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMacrovascular invasion (MaVI) defines advanced-stage hepatocellular carcinoma (HCC) and typically mandates systemic therapy, yet some guidelines advocate surgery or locoregional approaches. We conducted a systematic review and meta-analysis of overall survival (OS) in HCC with MaVI treated with approaches other than systemic therapy, enforcing stringent inclusion criteria to exclude studies lacking a minimal prognostic dataset and to improve cohort comparability. APPROACH AND
resultsPRISMA-guided methods were used (CRD420251051847). PubMed was searched (January 2008 to November 2024). Eligible studies reported OS for HCC with MaVI and provided baseline performance status and liver function; studies without adequate prognostic information were excluded. Data on OS at 1, 2, 3, and 5 years were extracted, and heterogeneity was assessed. Seventy-three studies met criteria (104 treatment arms; 10,329 patients). Despite a rigorous identification process, substantial heterogeneity persisted for most modalities ( I2 >80%), precluding robust pooling. Transarterial radioembolization (TARE) monotherapy was the only treatment with low heterogeneity ( I2 =0%) and showed a pooled 1-year OS of 34% (95% CI: 20%-48%). Apparent advantages of sequential strategies likely reflected confounding by indication and immortal-time bias, as only patients who lived long enough and were sufficiently fit proceeded through the full sequence. Data completeness declined beyond 12 months (missing OS: 0% at 1 y; 17.3% at 2 y; 32.7% at 3 y; 70.2% at 5 y).
conclusionsIn HCC with MaVI, 1-year OS is the most comparable endpoint across modalities. This analysis identifies TARE as the only consistently reproducible option, showing a 1-year survival of 34%. In contrast, surgery and sequential therapies remain confounded by substantial heterogeneity. Accordingly, stratified head-to-head trials comparing alternative modalities against immunotherapy are warranted.
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