Open Access

Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis

  • Authors:
    • Wangyi Xuan
    • Xiaoming Zhang
    • Yingying Fang
    • Yueming Zhang
    • Zhiyi Xiang
    • Yifei Yu
    • Qingping Wu
    • Xingfen Zhang
  • View Affiliations

  • Published online on: January 7, 2025     https://doi.org/10.3892/ol.2025.14868
  • Article Number: 122
  • Copyright: © Xuan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hepatocellular carcinoma (HCC) with coexisting portal vein tumor thrombus (PVTT) is associated with poor patient outcomes. The efficacy and safety of neoadjuvant therapy in patients with HCC with PVTT remain a subject of debate. In the present study, a comprehensive search of electronic databases, including PubMed, Web of Science, Embase and the Cochrane Library, was conducted to identify studies evaluating the outcomes of neoadjuvant therapy in patients with HCC and PVTT. The primary outcomes assessed were overall survival (OS) and relapse‑free survival (RFS), with complication rates as a secondary outcome. A total of six studies comprising 750 patients were included in the present meta‑analysis. The neoadjuvant therapy group exhibited significantly superior OS [hazard ratio (HR), 0.39; P<0.001] and RFS (HR, 0.31; P<0.001) compared with the primary hepatectomy control group. Compared with the control group, neoadjuvant radiotherapy improved OS (HR, 0.34; P<0.001) and RFS (HR, 0.24; P=0.004). While the neoadjuvant intervention subgroup exhibited an improved OS compared with controls (HR, 0.37; P=0.001), no significant difference in RFS was observed (HR, 0.11; P=0.095). Geographical analysis revealed that the Chinese subgroup demonstrated a significantly improved OS and RFS (HR, 0.41 for both; P<0.001), compared with the control group. However, the Japanese and Korean subgroups showed no improvement in OS (HR, 0.25; P=0.057) compared with the control group, and the results did not reach statistical significance. There were no significant differences between the groups in terms of blood transfusion, blood loss, operation time, bile leakage, ascites, peritoneal infection, postoperative bleeding, complications or mortality (all P>0.05). Overall, neoadjuvant therapy significantly improved survival outcomes in patients with HCC and PVTT without increasing complication rates, supporting its efficacy and manageable safety profile.
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March-2025
Volume 29 Issue 3

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Copy and paste a formatted citation
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Spandidos Publications style
Xuan W, Zhang X, Fang Y, Zhang Y, Xiang Z, Yu Y, Wu Q and Zhang X: Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis. Oncol Lett 29: 122, 2025.
APA
Xuan, W., Zhang, X., Fang, Y., Zhang, Y., Xiang, Z., Yu, Y. ... Zhang, X. (2025). Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis. Oncology Letters, 29, 122. https://doi.org/10.3892/ol.2025.14868
MLA
Xuan, W., Zhang, X., Fang, Y., Zhang, Y., Xiang, Z., Yu, Y., Wu, Q., Zhang, X."Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis". Oncology Letters 29.3 (2025): 122.
Chicago
Xuan, W., Zhang, X., Fang, Y., Zhang, Y., Xiang, Z., Yu, Y., Wu, Q., Zhang, X."Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis". Oncology Letters 29, no. 3 (2025): 122. https://doi.org/10.3892/ol.2025.14868