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中华普通外科学文献(电子版) ›› 2014, Vol. 08 ›› Issue (05) : 408 -411. doi: 10.3877/cma.j.issn.1674-0793.2014.05.017

所属专题: 文献

循证医学

肝外恶性肿瘤对合并肝癌的多原发癌患者生存影响的Meta分析
李一杰1, 黄创新2, 肖妹3, 曾庆安1,()   
  1. 1. 519000 珠海,中山大学附属第五医院普外二科
    2. 519000 珠海,中山大学附属第五医院骨外二科
    3. 519000 珠海,中山大学附属第五医院肿瘤化疗科
  • 收稿日期:2014-02-27 出版日期:2014-10-01
  • 通信作者: 曾庆安

Meta-analysis of the impact of extrahepatic primary malignancy on survival of patients with multiple primary malignancies involving hepatocellular carcinoma

Yijie Li1, Chuangxin Huang2, Mei Xiao3, Qing'an Zeng1,()   

  1. 1. The Second Department of General Surgery, the Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai 519000, China
  • Received:2014-02-27 Published:2014-10-01
  • Corresponding author: Qing'an Zeng
  • About author:
    Corresponding author: Zeng Qing'an, Email:
引用本文:

李一杰, 黄创新, 肖妹, 曾庆安. 肝外恶性肿瘤对合并肝癌的多原发癌患者生存影响的Meta分析[J/OL]. 中华普通外科学文献(电子版), 2014, 08(05): 408-411.

Yijie Li, Chuangxin Huang, Mei Xiao, Qing'an Zeng. Meta-analysis of the impact of extrahepatic primary malignancy on survival of patients with multiple primary malignancies involving hepatocellular carcinoma[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(05): 408-411.

目的

评价肝外恶性肿瘤对合并肝癌的多原发癌患者生存率的影响。

方法

系统回顾公开发表的比较合并肝癌的多原发癌患者和单患肝癌患者生存率且随访严密的临床研究,评估原始研究的质量,对符合条件的研究结果进行Meta分析,计算多原发癌相对单患肝癌死亡危险的优势比(OR),评价肝外恶性肿瘤对患者生存期的影响。

结果

共6篇文献符合入选标准,总样本量2 431例。包括肝癌合并多原发癌病例207例,死亡136例;单患肝癌组2 224例,死亡1 598例;合并OR=0.93,95%CI为0.67~1.28。

结论

肝外肿瘤既没增加也没降低死亡危险,合并肝癌的多原发癌并不意味预后更差,采取积极的治疗是患者获得长期生存的关键,相对于肝外肿瘤需要优先治疗肝癌。

Objective

To assess the impact of extrahepatic primary malignancy (EHPM) on survival of patients with multiple primary malignancies (MPM) involving hepatocellular carcinoma (HCC).

Methods

All studies published including survival comparison between MPM involving HCC and HCC-alone were systematically reviewed. The studies were evaluated strictly and adopted in rash quality by means of Meta analysis. The odds ratio (OR) for death during the time to follow-up between the patients with MPM involving HCC and HCC-alone were calculated. And the effect of EHPM for survival in patients with MPM involving HCC was evaluated.

Results

Totally six studies including 2 431 cases were analyzed. The cumulative cases in MPM involving HCC group were 207, in which 136 were dead, while in HCC-alone group were 2 224 and 1 598 respectively. The pooled OR was 0.93, with a 95% confidence interval (0.67,1.28).

Conclusions

The overall OR for death is neither decreased nor increased in patients with EHPM. MPM involving HCC does not imply a worse prognosis and those patients should not be excluded from curative therapies. We need to prioritize curative treatment intention for HCC independently of the EHPM.

表1 纳入本系统评价和Meta分析的一般资料
图1 肝外恶性肿瘤对合并肝癌的多原发癌患者生存影响Meta分析结果的漏斗图
图2 肝外恶性肿瘤对合并肝癌的多原发癌患者生存影响Meta分析森林图
表2 Meta分析结果汇总表
[1]
Zeng QA,Qiu J,Zou R, et al. Clinical features and outcome of multiple primary malignancies involving hepatocellular carcinoma: a long-term follow-up study[J]. BMC Cancer, 2012, 12: 148.
[2]
Fernandez-Ruiz M,Guerra-Vales JM,Castelbon-Fernandez FJ, et al. Multiple primary malignancies in Spanish patients with hepatocellular carcinoma: analysis of a hospital-based tumor registry[J]. J Gastroenterol Hepatol, 2009, 24(8): 1424-1430.
[3]
Nzeako UC,Goodman ZD,Ishak KG. Association of hepatocellular carcinoma in North American patients with extrahepatic primary malignancies[J]. Cancer, 1994, 74(10): 2765-2771.
[4]
Wong LL,Lurie F,Takanishi DM Jr. Other primary neoplasms in patients with hepatocellular cancer: prognostic implications?[J]. Hawaii Med J, 2007, 66(8): 204, 206-208.
[5]
Takayasu K,Kasugai H,Ikeya S, et al. A clinical and radiologic study of primary liver cancer associated with extrahepatic primary cancer[J]. Cancer, 1992, 69(1): 45-51.
[6]
Shimada M,Takenaka K,Fujiwara Y, et al. Characteristics of hepatocellular carcinoma associated with extrahepatic primary malignancies in southern Japan[J]. Am J Gastroenterol,1996, 91(4): 754-758.
[7]
Jemal A,Bray F,Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2): 69-90.
[8]
张红卫,黄超有,林树文, 等. 索拉非尼对肝癌术后早期肝再生的影响[J/CD]. 中华普通外科学文献:电子版, 2013, 7(6): 472-476.
[9]
陈东,赵鹏,陈伟, 等. 索拉非尼治疗晚期原发性肝癌的单中心经验[J/CD]. 中华普通外科学文献:电子版, 2012, 6(6): 507-512.
[10]
Hiraoka A,Hirooka M,Ochi H, et al. Importance of screening for synchronous malignant neoplasms in patients with hepatocellular carcinoma: impact of FDG PET/CT[J]. Liver Int, 2013, 33(7): 1085-1091.
[11]
Wu WC,Chen YT,Hwang CY, et al. Second primary cancers in patients with hepatocellular carcinoma: a nationwide cohort study in Taiwan[J]. Liver Int, 2013, 33(4): 616-623.
[12]
Bruix J,Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma[J]. Hepatology, 2005, 42(5): 1208-1236.
[13]
谭国胜,向贤宏,张冰, 等. 经导管动脉化疗栓塞在肝细胞癌骨转移治疗中的应用初探[J/CD]. 中华普通外科学文献:电子版, 2013, 7(1): 21-25.
[14]
黄亮,刘继红,元云飞, 等. 上皮性卵巢癌肝转移的治疗及预后影响因素[J/CD]. 中华普通外科学文献:电子版, 2008, 2(6): 479-483.
[15]
邱春辉,赵辉,陈湖岸, 等. 肝癌肝移植术后肿瘤复发的治疗策略[J/CD]. 中华普通外科学文献:电子版, 2011, 5(4): 320-325.
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