AIM To investigate the efficacy and safety of isolated hepatic perfusion(IHP) in the management of unresectable liver malignancies.METHODS Studies were identified manually and on-line by using Pub Med and EMBASE database.We formulate the eligibility criteria according to the PICOS elements,and accessed the quality of studies using the MINORS instrument.Data from all included studies were carefully investigated.We calculated the pooled response rate and incidences of mortality reported from all eligible studies by using the Meta-Analyst software,and we computed a pooled relative risk(RR) and 95%CI by using the Comprehensive Meta-Analysis software.Heterogeneity was quantified evaluated using I^2 statistic.RESULTS Eight studies,including 502 patients,were selected.Of these,six studies performed IHP,while the other two studies performed percutaneous IHP.The results showed that the pooled response rate was 60.8%(95%CI:53.1%-68%),I^2 = 37.1%.The median overall survival was 20 mo(range:12.1 to 25 mo) following IHP or PIHP.The pooled mortality rate was 5.4%(95%CI:2.5%-11.2%),I^2 = 37.5%.Prognostic factors predict the response to IHP or survival,and were reported in six studies.Meta-analysis demonstrated that Gender was not associated with overall survival(RR = 0.877,95%CI:0.564-1.365);however,carcino-embryonic antigen ≤ 30 ng/mL was associated with a significant improvement in survival outcomes with colorectal cancer patients(RR = 2.082,95%CI:1.371-3.163),and there was no significant heterogeneity.CONCLUSION The present systemic review and meta-analysis suggest that IHP and PIHP are potentially efficient and safe techniques for unresectable liver primary and secondary malignancies.
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