SynthesisWorld journal of surgical oncology2025
Neoadjuvant therapy for resectable hepatocellular carcinoma with portal vein tumor thrombus: an updated systematic review with meta-analysis.
Synthesis in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to compare survival outcomes of neoadjuvant therapy followed by surgery (Neo + Surgery) with surgery alone (Surgery) in patients with resectable hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).
methodsA comprehensive search of online databases was performed from January 1990 to May 2025. Relative outcomes of RFS and OS were synthesized. The perioperative outcomes were analyzed. A single-arm meta-analysis and subgroup analysis were conducted.
resultsEight studies involving 1024 participants (417 in the Neo + surgery group vs. 607 in the Surgery group) were included. The Neo + surgery group showed a significant advantage over the Surgery group in terms of the overall hazard ratio (HR) for RFS (HR = 0.42, 95% CI: 0.33 to 0.52, P < 0.001) and OS (HR = 0.47, 95% CI: 0.39 to 0.56, P < 0.001). The pooled proportion of complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), severe adverse events (AEs) rate, and surgical contraindication rate were 9.1% (95% CI: 1.6%-20.9%, P = 0.0028), 36.9% (95%CI: 25.4%-49.1%, P < 0.001), 43.5% (95%CI: 26.8%-61.0%, P < 0.001), 6.3% (95% CI: 1.7%-12.9%, P < 0.001), 18.4% (95% CI: 5.3%-36.3%, P < 0.001), and 15.9% (95%CI: 8.8%-24.5%, P < 0.001), respectively. No significant differences were observed between the Neo + surgery group and the Surgery group regarding perioperative outcomes.
conclusionThe meta-analysis confirms that Neo + Surgery is superior to Surgery in terms of RFS and OS for patients with resectable HCC and PVTT. Our findings suggest that neoadjuvant therapy may offer clinical benefit and should be considered in selected patients with resectable HCC and PVTT.
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