Image 4_Resection rates after conversion therapy for initially unresectable hepatocellular carcinoma: a systematic review and meta-analysis.tif

PROSPERO: CRD420261360108.</p>Results<p>Thirty-seven reports represented 36 unique studies; 34 studies involving 5,137 patients and 1,042 completed hepatectomies entered the quantitative synthesis. The crude aggregate resection rate was 20.3% (1,042/5,137), whereas the random-effects modeled pooled rate was 25.40% (95% CI, 20.74%-30.69%; I²=91.5%; tau²=0.5132). The Hartung-Knapp 95% CI was 20.12%-31.51%, and the prediction interval was 7.16%-60.04%.

Leave-one-out estimates ranged from 24.52% to 26.64%. Treatment-strategy differences were not statistically significant (Qm=5.17, df=2, P = 0.075). Publication-year meta-regression did not show a clear linear association (OR per decade 1.19, 95% CI 0.77-1.83; P = 0.440), and Egger’s test did not indicate significant funnel asymmetry (P = 0.381).</p>Conclusions<p>Approximately one-quarter of patients initiating conversion therapy underwent actual hepatectomy, but the crude and modeled estimates differ because substantial heterogeneity changes random-effects study weighting.

The pooled estimate is a cross-study, cross-era benchmark for multidisciplinary decision-making rather than a universal patient-level probability or a treatment-specific efficacy estimate.</p>Systematic Review Registration<p>www.crd.york.ac.uk/prospero/, identifier CRD420261360108.</p>