Letter to the editor regarding “125I seed implantation for hepatocellular carcinoma with portal vein tumor thrombus: A systematic review and metaanalysis”

With interest, we have read the recent paper by Yuan et al. ( [1] Yuan D. Gao Z. Zhao J. et al. (125)I seed implantation for hepatocellular carcinoma with portal vein tumor thrombus: A systematic review and meta-analysis. Brachytherapy. 2019; 18: 521-529 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar ) that was published in Brachytherapy in 2019. They concluded that 125I seed implantation could obtain good local control, improve the survival rate, and reduce the mortality risk and portal venous pressure in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). Before these results can be accepted, we have serious concerns about their use of the HR to estimate pooled survival rate and their study selection.