ArticleInternational journal of surgery (London, England)2026
Survival and safety outcomes of hepatectomy versus ablation in hepatocellular carcinoma within Milan criteria and clinically significant portal hypertension: a systematic review and meta-analysis.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe applicability and safety of hepatectomy in hepatocellular carcinoma (HCC) patients with clinically significant portal hypertension (CSPH) remain controversial. This study aimed to compare the safety and long-term outcomes of hepatectomy versus ablation in HCC patients within the Milan criteria and concomitant CSPH. MATERIALS AND
methodsFollowing the PRISMA 2020 guidelines, a systematic literature search was conducted across PubMed, Cochrane, and other databases from inception to 20 April 2025. AI-assisted screening was performed using AS Review. Meta-analysis was conducted using R software (v4.4.1). Fixed-effect or random-effect models were used to calculate the comprehensive effect magnitude for overall survival (OS) and recurrence-free survival (RFS). Sparse Bayesian meta-analysis was applied to postoperative complications. Individual patient data (IPD) reconstruction validated survival outcomes.
resultsSeven studies (1 RCT, 6 retrospective) involving 972 patients were included. Pooled analysis showed no significant difference in OS between ablation and hepatectomy (HR = 1.10, 95% CI: 0.76-1.61, P = 0.644), but hepatectomy significantly improved RFS (HR = 2.05, 95% CI: 1.54-2.71, P < 0.001). Adjusted analyses revealed nonsignificant RFS differences (HR = 1.63, 95% CI: 0.85-3.13, P = 0.151). Subgroup analysis demonstrated superior RFS with hepatectomy versus radiofrequency ablation (HR = 2.01, 95% CI: 1.18-3.42, P = 0.008), though OS remained comparable. Notably, hepatectomy conferred dual benefits in hepatitis B virus (HBV)-related HCC for both OS (HR = 1.45, P = 0.016) and RFS (HR = 1.90, P = 0.006). IPD reconstruction further supported hepatectomy's RFS advantage (HR = 1.81, P < 0.001). Ablation was associated with lower overall complication risks, particularly a 69% reduction in ascites (OR = 0.31).
conclusionsThis study suggests that the long-term survival rates of hepatectomy and ablation are comparable, but hepatectomy shows better recurrence control, especially in HBV-related cases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.