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Prognostic value of liver stiffness measurement in patients with hepatocellular carcinoma (HCC) treated by radiofrequency ablation: a meta-analysis
International Journal of Hyperthermia ( IF 3.1 ) Pub Date : 2021-07-12 , DOI: 10.1080/02656736.2021.1947529
Yongchao Zhang 1 , Hualei Chen 1 , Shanshan Chen 1 , Wei Li 1
Affiliation  

Abstract

Background

In patients with stage 0–A (as per Milan criteria) hepatocellular carcinoma (HCC) image-guided ablation is less invasive and requires shorter hospitalization than resection, but long-term prognosis is poorer. This meta-analysis was conducted to investigate whether liver stiffness measurement (LSM) could be used to predict prognosis in HCC patients after tumor ablation.

Methods

A literature search was conducted for all studies published till July 2020 in PubMed, Web of Science, Cochrane Library and EMBASE. Studies were included if they investigated the association between pretreatment LSM and prognosis in HCC patients treated with ablation. Subgroup analysis, meta-regression, publication bias assessment and sensitivity were conducted.

Results

Eight studies (with a total of 1276 HCC patients) were included in this meta-analysis. All patients were treated with radiofrequency ablation. Pooled results showed that high pretreatment LSM were associated with poor overall survival (OS) (hazard ratio [HR] = 4.31, 95% confidence interval [CI]: 2.27–8.20, p < .001) and recurrence-free survival (RFS), regardless of whether LSM was considered as a categorical variable (HR = 2.63, 95% CI = 1.63–4.22, p < .001) or as a continuous variable (HR = 1.02, 95% CI = 1.01–1.04, p = .003). Among studies treating LSM value as a categorical variable, liver stiffness measured using acoustic radio force impulse (ARFI) or transient elastography (TE) was significantly associated with RFS, but not liver stiffness measured using two-dimensional shear wave elastography (SWE).

Conclusions

High baseline LSM value appears to be associated with poor prognosis in HCC patients treated with radiofrequency ablation.



中文翻译:

肝脏硬度测量对射频消融治疗肝细胞癌(HCC)患者预后价值的荟萃分析

摘要

背景

对于 0-A 期(根据米兰标准)肝细胞癌 (HCC) 患者,图像引导消融术的侵入性较小,住院时间比切除术短,但长期预后较差。本荟萃分析旨在研究肝脏硬度测量 (LSM) 是否可用于预测肿瘤消融后 HCC 患者的预后。

方法

对 2020 年 7 月之前在 PubMed、Web of Science、Cochrane 图书馆和 EMBASE 上发表的所有研究进行了文献检索。如果研究调查了接受消融治疗的 HCC 患者的治疗前 LSM 与预后之间的关联,则这些研究被纳入。进行了亚组分析、元回归、发表偏倚评估和敏感性。

结果

该荟萃分析包括八项研究(共 1276 名 HCC 患者)。所有患者均接受射频消融治疗。汇总结果显示,高治疗前 LSM 与较差的总生存期 (OS)(风险比 [HR] = 4.31,95% 置信区间 [CI]:2.27–8.20,p  < .001)和无复发生存期 (RFS) 相关,无论 LSM 是被视为分类变量(HR = 2.63, 95% CI = 1.63–4.22, p  < .001)还是连续变量(HR = 1.02, 95% CI = 1.01–1.04, p = .003)。在将 LSM 值视为分类变量的研究中,使用声波无线电力脉冲 (ARFI) 或瞬态弹性成像 (TE) 测量的肝脏硬度与 RFS 显着相关,但与使用二维剪切波弹性成像 (SWE) 测量的肝脏硬度无关。

结论

高基线 LSM 值似乎与接受射频消融治疗的 HCC 患者的不良预后相关。

更新日期:2021-07-13
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