title: Efficacy of transarterial chemoembolization for hepatocellular carcinoma with portal vein thrombosis: a meta-analysis.
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) is commonly used to treat advanced hepatocellular carcinoma (HCC), but less is known regarding safety and efficacy of TACE in patients with HCC and portal vein tumour thrombosis (PVTT). The objective of this study was to evaluate the effect of TACE treatment on 1-year survival in patients with HCC and PVTT.
  
  
  METHODS
  Medline, EMBASE, CENTRAL databases (until July 2013) were searched for studies that evaluated the efficacy of TACE with regard to survival in patients with HCC and PVTT. One-year survival rate, the primary end point, was compared between patients who received TACE and those who received control treatment.
  
  
  RESULTS
  Five prospective studies were identified that assessed the efficacy of TACE on survival. These studies included 600 patients: 335 received TACE therapy and 226 received control treatments. Three of the five studies reported 1-year survival data and were used in the meta-analysis. The combined odds ratio (3.079, 95% confidence interval = 1.094-8.662) indicated that patients who received TACE had a significantly better 1-year survival rate compared with patients in the control group (P = 0.033).
  
  
  CONCLUSIONS
  There are several limitations to this analysis that should be considered when interpreting the findings. The studies used different treatment regimens as controls or with TACE. These differences across the studies may have altered the 1-year survival outcomes in each study and confounded our analysis. This meta-analysis showed that TACE improves the 1-year survival of patients with HCC and PVTT. However, additional prospective controlled trials are required to further substantiate these findings.
authors.affiliation: Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Leng
authors.affiliation: Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yin-Zhe
authors.initials: YZ
authors.lastname: Xu
authors.affiliation: Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing, China. lengjj@gmail.com.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Dong
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011169:Portal Vein; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents
keywords: hepatocellular carcinoma; meta-analysis; portal vein tumour thrombosis; survival; transarterial chemoembolization