Liver transplantation versus resection for treatment of hepatocellular carcinoma: A meta-analysis

Objective: To systematically evaluate the efficacy of liver transplantation (OLT) and resection (RT) for hepatocellular carcinoma (HCC) with meta-analysis. Methods: The literature on the therapeutic effect of OLT and RT on HCC was retrieved combined with manual retrieval from Pubmed, EMBASE, Ovid, ScienceDirect, Springerlink, EBSCO, CBM, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Weipu Database published between 1990 and 2010 in China. RevMan 5.0 software was used for data analysis. Results: According to the selection criteria, 9 clinical trials were selected finally. The combined results of meta-analysis with fixed effect model showed that the 1-year survival rate was similar (OR=1.26, 95% CI 0.93-1.17, P=0.13); 3-year survival rate in HCC patients was higher with OLT than with RT (OR=1.68, 95% CI 1.31-2.17, P<0.01); 5-year survival rate was higher with OLT than with RT (OR=2.17, 95% CI 1.63-2.89, P<0.01); 5-year survival disease-free rate was higher with OLT than with RT (OR=5.07, 95% CI 3.27-7.86, P<0.01), and the recurrence rate of HCC was lower with OLT than with RT (OR=0.10, 95% CI 0.06-0.14, P<0.01). Conclusion: OLT and RT are both effective surgical methods for treating HCC, but OLT leads to a better prognosis in HCC than RT.