Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Effect of transjugular intrahepatic portosystemic shunt on transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis

1.

Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China

2.

Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University State Key Laboratory of Oncology in South China, Guangzhou, China

3.

Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou, China

4.

Department of Biostatistics and Preventive Medicine, School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, China

Diagn Interv Radiol 2021; 27: 671-676
DOI: 10.5152/dir.2021.20358
Read: 427 Downloads: 104 Published: 13 November 2020

PURPOSE 
Hepatocellular carcinoma (HCC) usually occurs accompanied by portal hypertension. Transcatheter arterial chemoembolization (TACE) is recommended as an effective treatment in HCC. Recent studies had conflicting results regarding the effectiveness and safety of TACE for HCC in patients with transjugular intrahepatic portosystemic shunt (TIPS). This meta-analysis aimed to evaluate the influence of TIPS on the effectiveness and safety of TACE for patients with HCC.

METHODS
A comprehensive search of studies among PubMed, Web of Science and Cochrane Library was conducted, from the earliest publishing date to January 27th, 2020. Statistical analyses were all performed using the Stata 13.0 software. I2 index statistic was used to assess heterogeneity.

RESULTS
Six studies with a total of 536 patients with HCC were included in the analysis. The pooled response rate was 51% (95% CI: 25% to 77%) with a significant heterogeneity (I2=93.3%, p < 0.001). The TACE + TIPS group had an inferior response rate than the non-TIPS group, but the difference had no statistical significance (p = 0.171) and heterogeneity was low (I2=0.00%, p = 0.490). Pooled hepatic failure rate was 8.8% (95% CI: 5.2% to 12.4%) with low heterogeneity (I2=0.0%, p = 0.747). But the pooled hepatic failure rate increased to 12.7% (95% CI: 5.7% to 19.7%) with low heterogeneity (I2=11.5%, p = 0.323) if the patients who received TIPS after TACE were excluded.

CONCLUSION
TIPS does not influence the effectiveness of TACE, but attention should be paid to the risk of hepatic failure.

You may cite this article as: Chen X, Qiu Z-K, Wang G-B, Chen X-L, Zhang F-J, Gao F. Effect of transjugular intrahepatic portosystemic shunt on transarterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis. Diagn Interv Radiol 2021; 27: 671–676

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