Meta‐analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma

• Published in: Alimentary pharmacology & therapeutics 2003-05, Vol.17 (10), p.1247-1261
• Main Authors: Mathurin, P., Raynard, B., Dharancy, S., Kirzin, S., Fallik, D., Pruvot, F.‐R., Roumilhac, D., Canva, V., Paris, J.‐C., Chaput, J.‐C., Naveau, S.
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - therapeutic use; Biological and medical sciences; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - surgery; Chemotherapy, Adjuvant; Controlled Clinical Trials as Topic; Drug Therapy, Combination; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - surgery; Medical sciences; Neoplasm Recurrence, Local - etiology; Postoperative Care; Preoperative Care; Randomized Controlled Trials as Topic; Survival Analysis; Treatment Outcome
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.2003.01580.x

Summary Aim : To evaluate adjuvant modalities after curative resection for hepatocellular carcinoma using a meta‐analysis of randomized and non‐randomized controlled trials. Methods : In a first step, a meta‐analysis of randomized controlled trials was carried out. Sensitivity analyses after inclusion of non‐randomized controlled trials were performed. Four therapeutic modalities were evaluated: pre‐operative transarterial chemotherapy, post‐operative transarterial chemotherapy, systemic chemotherapy and a combination of systemic and transarterial chemotherapy. Results : Only post‐operative transarterial chemotherapy improved survival significantly at 2 years [difference, 22.8%; confidence interval (CI), 8.6–36.9%; P = 0.002] and 3 years (difference, 27.6%; CI, 8.2–47.1%; P = 0.005), and decreased the probability of no recurrence at 1 year (difference, 28.8%; CI, 16.7–40.8%; P