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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2021

01-12-2021 | Liver Resection | Hepatobiliary Tumors

Impact of Postoperative Complications on Long-Term Survival After Resection of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Authors: Junjie Kong, MD, Guangbing Li, MD, Jiawei Chai, MM, Guangsheng Yu, MD, Yong Liu, MD, Jun Liu, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2021

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Abstract

Background

Controversy exists over the relationship between postoperative complications (POCs) and long-term survival for hepatocellular carcinoma (HCC) after hepatectomy. This study aimed to evaluate the impact of POCs on overall survival (OS) and disease-free survival (DFS) for HCC after liver resection.

Patients and Methods

The PubMed, EMBASE, and Cochrane Library databases were used to search for eligible studies published through 18 April 2020, and studies comparing the long-term outcomes between HCC patients with and without POCs after hepatectomy were included. A random-effects model was used to calculate the pooled hazard ratio (HR) with a 95% confidence interval (CI). Subgroup analysis and meta-regression were performed to assess the potential influence of study-, patient-, and tumor-related factors on the relationship between POCs and oncologic outcomes and to adjust their effect. This study was registered at the International Prospective Register of Systematic Reviews (CRD42019136109).

Results

Thirty-seven studies, including 14,096 patients, were deemed eligible and included in this study. Compared with those without POCs, patients who developed POCs had a significant reduction in OS (HR 1.39, 95% CI 1.28–1.50, P < 0.001; prediction interval 1.04–1.85) and tended to have worse DFS (HR 1.25, 95% CI 1.16–1.35, P < 0.001; prediction interval 0.98–1.60). Contour-enhanced funnel plots suggested a risk of publication bias. Subgroup analysis and meta-regression showed that POCs remained a threat to OS and DFS regardless of the influence of clinicopathological factors.

Conclusion

This study demonstrated that POCs had an adverse impact on OS and DFS in HCC patients after liver resection.
Appendix
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Metadata
Title
Impact of Postoperative Complications on Long-Term Survival After Resection of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Authors
Junjie Kong, MD
Guangbing Li, MD
Jiawei Chai, MM
Guangsheng Yu, MD
Yong Liu, MD
Jun Liu, MD, PhD
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-10317-2

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