BackgroundThis review evaluates the efficacy and safety of therapies for hepatocellular carcinoma (HCC) with hepatic vein tumor thrombus (HVTT), inferior vena cava tumor thrombus (IVCTT), and/or right atrium tumor thrombus (RATT).Research design and methodsA systematic review of PubMed, EMBASE, Cochrane Library, and Wanfang databases up to 22 August 2024, was conducted, focusing on overall survival (OS), progression -free survival (PFS), and adverse reactions.ResultsSeven studies involving 453 patients were analyzed. Treatment strategies included surgery alone, local +/- systemic therapy, and surgery with adjuvant therapy. The pooled 1-, 3-, and 5-year OS rates for all patients were 63.3%, 21.6% , and 8.3%, respectively. Surgery with adjuvant therapy achieved the highest 1-year OS, while local +/- systemic therapy led to the best 5-year OS. The pooled 1-, 3-, and 5-year PFS rates for all patients were 56.8%, 9.4%, and 1.6%, respectively. Surgery alone commonly caused ascites and pleural effusion; the local +/- systemic therapy commonly caused hepatic dysfunction and platelet abnormalities; and surgery with adjuvant therapy commonly caused peritoneal abscess.ConclusionLocal +/- systemic therapy provided the best long-term OS and manageable complications among the therapeutic strategies for HCC with HVTT, IVCTT, and/or RATT.RegistrationPROSPERO, (CRD42024573152)
[1]Kunming Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, Kunming 650101, Peoples R China.
[2]Hebei Med Univ, Coll Basic Med, Shijiazhuang, Peoples R China.
[3]Zhejiang Univ, Sch Med, Dept Cardiac Surg, Hangzhou, Peoples R China.
[4]Kunming Med Univ, Affiliated Hosp 2, Dept Surg Educ & Res, Kunming, Peoples R China.
[5]Yunnan Yunke Biotechnol Inst, Kunming, Peoples R China.
(8.0+极速模式)