Thrombocytopenia for prediction of hepatocellular carcinoma recurrence: Systematic review and meta-analysis - PubMed (original) (raw)

Meta-Analysis

. 2015 Jul 7;21(25):7895-906.

doi: 10.3748/wjg.v21.i25.7895.

Kai Qu 1, Jian-Bin Bi 1, Su-Shun Liu 1, Jing-Yao Zhang 1, Si-Dong Song 1, Ting Lin 1, Xin-Sen Xu 1, Yong Wan 1, Ming-Hui Tai 1, Hao-Chen Liu 1, Ya-Feng Dong 1, Chang Liu 1

Affiliations

Meta-Analysis

Thrombocytopenia for prediction of hepatocellular carcinoma recurrence: Systematic review and meta-analysis

Qing Pang et al. World J Gastroenterol. 2015.

Abstract

Aim: To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma (HCC).

Methods: We searched the PubMed, EMBASE, and Web of Science databases to obtain eligible studies. The hazard ratios (HRs) values and 95% confidence intervals (CIs) were pooled by random effects model. Subsequently, we estimated the heterogeneity, performed a sensitivity analysis, determined the publication bias, and performed subgroup and meta-regression analyses. Study quality was assessed by using the Oxford Center for Evidence Based Medicine tool.

Results: We identified 18 eligible studies by retrieval (published during 2000-2014). Out of the 4163 patients with HCC who were recruited, 2746 (66.0%) experienced recurrence. In general, our meta-analysis suggested that low platelet count (PLT) before therapy significantly increased the probability of postoperative recurrence (HR = 1.53, 95%CI: 1.29-1.81). PLT was also valuable in the prediction of intrahepatic distant recurrence (HR = 1.49, 95%CI: 1.25-1.77). Subgroup and meta-regression analyses identified various therapeutic modalities as the source of a high degree of heterogeneity. The pooled HR values showed no obvious change when a single study was removed, but otherwise, an opposite-effects model was used. In addition, no significant publication bias was detected.

Conclusion: Thrombocytopenia before treatment might be an inexpensive and useful predictor of postoperative recurrence in patients with HCC.

Keywords: Blood platelets; Hepatocellular carcinoma; Prognosis; Recurrence; Thrombocytopenia.

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Figures

Figure 1

Figure 1

Flow chart of the search strategy and study selection.

Figure 2

Figure 2

Effect of platelet count on hepatocellular carcinoma recurrence.

Figure 3

Figure 3

Effect of platelet count on hepatocellular carcinoma recurrence in patients who underwent liver resection (A) and RFA (B), on distant recurrence (C), and on recurrence in patients with hepatitis C virus-related hepatocellular carcinoma (D).

Figure 4

Figure 4

Influence analysis of our included studies.

Figure 5

Figure 5

Begg’s (A) and Egger’s (B) plots of our included studies.

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