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We read with great interest the leading article by Bruix et al 1 published in Gut. This article recommended palliative treatments for patients with hepatocellular carcinoma (HCC) involving macrovascular invasion, multiple tumours, or portal hypertension.
With better patient selection and improvement of perioperative care, liver resection (LR) offers the most consistent and clinically meaningful long-term survival in HCC over the past 20 years, which has been documented by both Eastern and Western centres.2 ,3 However, Western official guidelines do not recommend LR for treating intermediate and advanced stage HCC.4 ,5 Here, we systematically searched PubMed database for studies investigating the safety and efficacy of LR for treating patients with HCC involving macrovascular invasion, multiple tumours (≥2) or portal hypertension. We only included studies which were published in English on …
Contributors J-HZ and L-QL conceived the study, and J-HZ and YK designed the search strategy and statistical analysis. J-HZ, YK, and Y-YW collected the data. J-HZ drafted and revised the manuscript. J-HZ and L-QL are guarantors of the study. All authors had full access to all the data in the study and take responsibility for data integrity and accuracy of the data analysis. All authors approved the final version of the article.
Funding This study was supported by the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (nos. Z2012345 and Z2014241) and Youth Science Foundation of Guangxi Medical University (no. GXMUYSF201302).
Competing interests None.
Ethics approval This was a comprehensive review, and all the included studies by the respective authors have obtained the approval from their own institutions.
Provenance and peer review Not commissioned; externally peer reviewed.