Article
Reference
Shorter survival after liver pedicle clamping in patients undergoing liver resection for hepatocellular carcinoma revealed by a systematic
review and meta-analysis
WASSMER, Charles-Henri, et al .
Abstract
Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma (HCC) having a high rate of recurrence, evidences demonstrating an eventual association with pedicle clamping is strongly needed. We did a systematic review of the literature until April 2020, looking at studies reporting the impact of liver pedicle clamping on long-term outcomes in patients undergoing liver resection for HCC. Primary and secondary outcomes were overall survival (OS) and disease-free survival, respectively. Results were obtained by random-effect meta-analysis and expressed as standardized mean difference (SMD). Eleven studies were included, accounting for 8087 patients. Results of seven studies were pooled in a meta-analysis. Findings indicated that, as compared to control patients who did not receive liver pedicle clamping, those who did had a significantly shorter OS (SMD = -0.172, 95%CI:
-0.298 to -0.047, p = 0.007, I2 = 76.8%) and higher tumor recurrence [...]
WASSMER, Charles-Henri, et al . Shorter survival after liver pedicle clamping in patients undergoing liver resection for hepatocellular carcinoma revealed by a systematic review and meta-analysis. Cancers , 2021, vol. 13, no. 4, p. 637
DOI : 10.3390/cancers13040637 PMID : 33562666
Available at:
http://archive-ouverte.unige.ch/unige:155353
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Supplementary Material
Shorter Survival after Liver Pedicle Clamping in Patients Undergoing Liver Resection for
Hepatocellular Carcinoma Revealed by a Systematic Review and Meta-Analysis
Charles-Henri Wassmer, Beat Moeckli, Thierry Berney, Christian Toso and Lorenzo A. Orci
Table S1: Meta-analysis comparing baseline characteristics of the study groups.
Number of Studies Measure of Effect Pooled Estimate 95% Confidence Interval p Value
Gender (M : F) 11 Odds ratio 0.99 0.89 to 1.11 0.961
Underlying liver cirrhosis 11 Odds ratio 1.89 0.81 to 4.38 0.139
Alpha-feto protein (U/L) 5 Weighted mean difference 411.59 [U/L] -965.31 to 1788.5 0.558
Tumor size (cm) 7 Weighted mean difference 0.10 [cm] -0.366 to 0.568 0.673
Multinodular hepatocellular carcinoma 11 Odds ratio 1.02 0.88 to 1.19 0.812
