Abstract | AIMS: Numerous postoperative therapies for preventing recurrence of hepatocellular carcinoma (HCC) have been reported, but their efficacy remains controversial and knowledge about adverse effects is limited. A systematic review of randomized controlled trials (RCTs) was performed to gain a comprehensive picture of the efficacy and risks of these therapies. METHODS: MEDLINE, EMBASE and the Cochrane Library were systematically searched through July 2011. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. RESULTS: A total of 2989 patients from 28 RCTs involving 10 postoperative therapies were included. For interferon therapy, the estimated RR for the 2-year recurrence rate was 0.84 (95% CI 0.73-0.97, P = 0.02) and the overall survival (OS) was 1.15 (95% CI 1.07-1.22, P < 0.001). Postoperative therapy with the vitamin K2 analog did not lead to a significant reduction in the 1-year recurrence rate, with a pooled RR of 0.60 (95% CI 0.28-1.27, P = 0.18). However, it did slightly improve the 1-year OS, with a pooled RR of 1.03 (95% CI 1.00-1.05, P = 0.03). Transarterial chemotherapy with or without embolization, adoptive immunotherapy and heparanase inhibitor PI-88 therapy may delay tumor recurrence. The effects of acyclic retinoid, lipiodol-iodine-131 and tumor vaccine treatment were promising but require further study. All postoperative therapies except interferon administered intramuscularly were well tolerated by the majority of patients. CONCLUSIONS:
|
Authors | J-H Zhong, H Li, L-Q Li, X-M You, Y Zhang, Y-N Zhao, J-Y Liu, B-D Xiang, G-B Wu |
Journal | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
(Eur J Surg Oncol)
Vol. 38
Issue 4
Pg. 286-95
(Apr 2012)
ISSN: 1532-2157 [Electronic] England |
PMID | 22281155
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)
|
Copyright | © 2012 Elsevier Ltd. All rights reserved. |
Chemical References |
- Adjuvants, Immunologic
- Antineoplastic Agents
- Interferons
|
Topics |
- Adjuvants, Immunologic
(administration & dosage)
- Antineoplastic Agents
(administration & dosage)
- Carcinoma, Hepatocellular
(drug therapy, mortality, surgery)
- Combined Modality Therapy
- Disease-Free Survival
- Humans
- Interferons
(administration & dosage)
- Liver Neoplasms
(drug therapy, mortality, surgery)
- Neoplasm Recurrence, Local
(drug therapy, mortality, surgery)
- Randomized Controlled Trials as Topic
- Treatment Outcome
|