Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 11 / 16 / 2019

Articles

TIPS Is Not Associated with a Higher Risk of Developing HCC in Cirrhotic Patients: A Systematic Review and Meta-analysis

ORIGINAL ARTICLE

TIPS Is Not Associated with a Higher Risk of Developing HCC in Cirrhotic Patients: A Systematic Review and Meta-analysis

Bin Chen1, Long Pang2, Hao-Bin Chen2, Dong-Bo Wu1, Yong-Hong Wang1 and En-Qiang Chen*,1

1Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
2West China School of Medicine, Sichuan University, Chengdu, China
*Correspondence to: En-Qiang Chen, Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Wuhou District, Chengdu 610041, China. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2019;7(3):232-237 DOI: 10.14218/JCTH.2019.00007
Received: January 27, 2019 Accepted: May 5, 2019 Published online: June 14, 2019

Abstract

Background and Aims: The association between portal-systemic shunt and hepatocellular carcinoma (HCC) development in patients who have cirrhosis is still controversial. This systematic review with meta-analysis was performed to systematically clarify the potential role of portal-systemic shunt in the development of HCC.

Methods: The PubMed, Embase, and Cochrane Library databases were searched for potentially eligible literature. Meta-analysis with random-effects model was performed to combine the incidence rates of HCC after portal-systemic shunt. Finally, seven studies were included. In the present review, we mainly focused on 859 patients (365 in the transjugular intrahepatic portal-systemic shunt (TIPS) group and 494 in the non-TIPS group) from five studies to analyze incidence rates after TIPS.

Results: At the end of follow-up, there were 66 (18%, 66/365) patients who developed HCC after TIPS intervention and 63 (13%, 63/494) patients who developed HCC after non-TIPS treatments. Pooled estimates with random-effects model did not demonstrate a significant increase of incidence of HCC after TIPS (risk ratio: 1.37 [confidence interval (CI): 0.96 to 1.97]; p = 0.08) compared with non-TIPS treatments. Subgroup analyses for those patients with transplanted liver also did not detect a significant difference between the TIPS group and non-TIPS group (risk ratio: 1.10 [CI: 0.59 to 2.07]; p = 0.75).

Conclusions: Current evidence suggests that portal-systemic shunt is not associated with a higher risk of HCC development in cirrhotic patients.

Keywords

Transjugular intrahepatic portal-systemic shunt (TIPS), Hepatocellular carcinoma (HCC), Hepatic cirrhosis, Systematic review

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