Postoperative use of the chemopreventive vitamin K2 analog in patients with hepatocellular carcinoma.

Abstract

AIM:

To evaluate the chemopreventive efficacy of vitamin K2 (VK2) analog in patients with hepatocellular carcinoma (HCC) after curative hepatic resection or local ablation, since a recent randomized control trial (RCT) and systematic review have given contradictory results.

METHODS:

MEDLINE, EMBASE and Cochrane library databases were systematically searched through the end of May 2012. Meta-analysis of RCTs and cohort studies was performed to estimate the effects of the VK2 analog on tumor recurrence rate and overall survival (OS). Risk ratios (RRs) and 95% confidence intervals (95% CIs) were calculated.

RESULTS:

Six RCTs and one cohort study involving a total of 930 patients were included. VK2 analog therapy did not reduce the 1-year recurrence rate, with a pooled RR of 0.67 (95% CI 0.39-1.13, p = 0.13). However, VK2 analog therapy was associated with a significant reduction in the 2- and 3-year tumor recurrence rates, with respective pooled RRs of 0.65 (95% CI 0.51-0.83, p<0.001) and 0.70 (95% CI = 0.58-0.85, p<0.001). The therapy was also associated with a significant improvement in 1-, 2-, and 3-year OS, with respective pooled RRs of 1.03 (95% CI 1.01-1.05, p = 0.02), 1.11 (95% CI 1.03-1.19, p = 0.005) and 1.14 (95% CI 1.02-1.28, p = 0.02). None of the studies reported adverse effects attributable to VK2 analog therapy.

CONCLUSION:

The VK2 analog may reduce recurrence rate after 1 year and improve OS in HCC patients as early as 1 year. However, these findings should be considered preliminary since the majority of patients came from an RCT with survival data out to only 1 year. More extensive studies with larger sample sizes and longer follow-up are needed.

• Authors: Jian-Hong Zhong, Xin-Shao Mo, Bang-De Xiang, Wei-Ping Yuan, Jin-Fang Jiang, Gui-Sheng Xie, Le-Qun Li
• Journal: PloS one (PLoS One) Vol. 8 Issue 3 Pg. e58082 ( 2013) ISSN: 1932-6203 [Electronic] United States
• PMID: 23505456 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review)

Chemical References

• Vitamin K 2

Topics

• Carcinoma, Hepatocellular (drug therapy, mortality, surgery)
• Chemoprevention
• Humans
• Liver Neoplasms (drug therapy, mortality, surgery)
• Postoperative Care
• Publication Bias
• Recurrence
• Risk
• Treatment Outcome
• Vitamin K 2 (adverse effects, analogs & derivatives, therapeutic use)