title: A mixed analysis comparing nine minimally invasive surgeries for unresectable hepatocellular carcinoma patients.
abstract: Hepatocellular carcinoma (HCC) is usually managed by the transcatheter arterial chemoembolization (TACE). However, this technique has been challenged since severe complications have been observed in clinical practices. As a result, clinicians have started to seek other minimally invasive surgeries with equivalent efficacy. The corresponding surgeries were assessed by the five outcomes: complete response (CR), partial response (PR), stable disease (SD), progression disease (PD) and objective response rate (ORR). Direct meta-analysis and network meta-analysis were performed and the results were represented by odds ratios (OR), 95% confidence and credential intervals. Furthermore, the value of surface under the cumulative ranking curve (SUCRA)was calculated to provide corresponding rankings.Seventeen studies were incorporated into the network meta-analysis which indicated that TACE + external-beam radiation therapy (EBRT) and drug-eluting beads (DEB) were better than TACE at controllingPD. TACE + EBRT demonstrated their advantages compared to TARE-90Y.However, network meta-analysis comparison showed no significant difference between the corresponding eight treatments with respect to CR, PR, SD and ORR. Moreover, the SUCRA suggested that TACE+EBRT were better than other treatments at treating unresectableHCC.Based on the present results of this network meta-analysis, TACE + EBRT was more effective than the other seven minimally invasive surgeries and therefore it is considered as the optimal treatment for HCC.
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Ran
authors.initials: R
authors.lastname: Tao
authors.affiliation: Department of Infectious Diseases,The Central Hospital of Enshi Autonomous Prefecture, Enshi Clinical College of Wuhan University, Wuhan, Hubei, China.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Interal Medicine-Oncology, The Central Hospital of Enshi Autonomous Prefecture, Enshi Clinical College of Wuhan University, Wuhan, Hubei, China.
authors.forename: Ruizhi
authors.initials: R
authors.lastname: Ran
authors.affiliation: Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, Hubei, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Hongyue
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Kong
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Qiqin
authors.initials: Q
authors.lastname: Song
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Savaid Medical School, University of Chinese Academy of Sciences Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
authors.forename: Likui
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: Jiaquan
authors.initials: J
authors.lastname: Huang
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: network meta-analysis; transcatheter arterial chemoembolization; unresectable hepatocellular carcinoma