A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma

Lin, Yuanqiang; Wen, Qiang; Guo, Li; Wang, Hui; Sui, Guoqing; Sun, Zhixia

doi:10.1080/02656736.2018.1507047

Cited by 11 publications

(9 citation statements)

References 58 publications

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“…Previous network meta-analyses have been performed, although their conclusions should be interpreted in an informed fashion. 18,19,78,79 Firstly, some previous NMAs included trials which evaluated patients beyond early stage HCC criteria (i.e. solitary HCC >5 cm or multifocal HCC >3 cm).…”

Section: Discussionmentioning

confidence: 99%

Treatment strategies for early stage hepatocellular carcinoma: a systematic review and network meta-analysis of randomised clinical trials

Kamarajah

Bundred

Littler

et al. 2021

HPB

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Section: Discussionmentioning

confidence: 99%

Treatment strategies for early stage hepatocellular carcinoma: a systematic review and network meta-analysis of randomised clinical trials

Kamarajah

Bundred

Littler

et al. 2021

HPB

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“…A network meta-analysis by Lin et al [ 105 ] analyzed data in 5 RCTs and compared the efficacies of different interventional techniques for treatment of early stage hepatocellular carcinoma, including SR, RFA, MWA, PEI, CRA, laser ablation and external beam radiotherapy. However, in this previous meta-analysis, only RCTs were included, with some high-quality cohort studies being excluded.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of various primary treatment strategies for very early and early hepatocellular carcinoma: a network meta-analysis

Lin

Song³

2021

Cancer Cell Int

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Background Several treatments are available for treatment of early and very early-stage Hepatocellular Carcinoma, also known as small Hepatocellular Carcinoma (SHCC). However, there is no consensus with regards to the efficacies of these methods. We aimed at identifying the most effective initial treatment strategy for SHCC through Bayesian network meta-analyses. Methods Studies published between January, 2010, and February, 2021 were searched in EMBASE, Cochrane Library, PubMed and Web of science databases, and conference proceedings for trials. The included studies reported the survival outcomes of very early and early Hepatocellular Carcinoma patients subjected to radiofrequency ablation (RFA), microwave ablation (MWA), surgical resection (SR), transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), minimally invasive liver surgery (MIS), stereotactic body radiotherapy (SBRT) and cryoablation (CA). Then, data were extracted from studies that met the inclusion criteria. Patient survival data were retrieved from the published Kaplan–Meier curves and pooled. A Bayesian random-effects model was used to combine direct and indirect evidence. Results A total of 2058 articles were retrieved and screened, from which 45 studies assessing the efficacies of 8 different treatments in 11,364 patients were selected. The included studies had high methodological quality. Recurrence free survival* (progression/recurrence/relapse/disease/tumor-free survival were combined and redefined as RFS*) and overall survival (OS) outcomes were highest in MIS-treated patients (HR 0·57, 95% confidence intervals [CI] 0·38–0·85; HR 0.48,95% CI 0.36–0.64, respectively), followed by SR-treated patients (HR 0.60, 95% CI 0.50–0.74; HR 0.62, 95% CI 0.55–0.72, respectively). TACE was highly efficacious (58.9%) at decreasing the rates of major complications. Similar findings were obtained through sensitivity analysis, and in most of the prognostic subgroups. Conclusions MIS and SR exhibited the highest clinical efficacies, however, they were associated with higher rates of complications. Ablation is effective in small tumors, whereas SBRT is a relatively promising treatment option for SHCC. More well-designed, large-scale randomized controlled trials should be performed to validate our findings.

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“…In summary, overall 5- and 10-year survival rates are similar to surgical resection, while there were large differences in local tumour control rates depending on the treatment strategy for insufficient ablative margin [44-49]. Most meta-analyses also demonstrated that ablation has similar OS but inferior local tumour control rates compared to resection [32, 46, 47]. However, two recent meta-analyses showed that resection had better recurrence-free and OS than RFA [32, 46].…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…Most meta-analyses also demonstrated that ablation has similar OS but inferior local tumour control rates compared to resection [32, 46, 47]. However, two recent meta-analyses showed that resection had better recurrence-free and OS than RFA [32, 46].…”

Section: Clinical Outcomesmentioning

confidence: 99%

The What, the Why, and the How of Liver Ablations: A Practical Guide for the Medical Oncologist

et al. 2021

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Interventional oncology plays a major role within modern oncological patient management. Image-guided thermal ablation has been recognized as a successful local therapeutic option in patients with primary and secondary malignant liver diseases, as also recalled by the recent European Society of Medical Oncology (ESMO) guidelines on colorectal metastases. As image-guided treatments may be as effective as surgery in selected patients with liver lesions, the clinical oncologist should be familiar with the indications, risks, and technical aspects of liver ablation in order to provide their patients with the best outcomes. This article provides a broad overview of the most commonly used ablation techniques and highlights the most relevant technical aspects such as the ideal setting in the operating theatre; which image-guided methods are available, including the growing application of fusion imaging; or contrast-enhanced ultrasound for guiding/monitoring the procedure. A further aim is to expand the knowledge among medical oncologists about liver ablation procedures and to provide insights into the future perspectives of percutaneous minimally invasive procedures in the liver.

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A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma

Abstract: View related articles View Crossmark data Citing articles: 2 View citing articles A network meta-analysis on the efficacy and prognosis of different interventional therapies for early-stage hepatocellular carcinoma

Cited by 11 publications

References 58 publications

Treatment strategies for early stage hepatocellular carcinoma: a systematic review and network meta-analysis of randomised clinical trials

Treatment strategies for early stage hepatocellular carcinoma: a systematic review and network meta-analysis of randomised clinical trials

Efficacy and safety of various primary treatment strategies for very early and early hepatocellular carcinoma: a network meta-analysis

The What, the Why, and the How of Liver Ablations: A Practical Guide for the Medical Oncologist

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