Comparative Effectiveness of Adjuvant Treatment for Resected Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis

Liu, Ying; Wang, Yuzhu; Guo, Xu; He, Yu; Zhou, Jian; Lv, Qianzhou; Huang, Xiaowu; Li, Xiaoyü

doi:10.3389/fonc.2021.709278

Cited by 11 publications

(16 citation statements)

References 62 publications

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“…In the stratification analysis, young patients with early-stage HCC who received LT combined with chemotherapy had a superior survival (HR, 0.36; 95% CI: 0.19-0.66; P interaction=0.0004) compared with non-surgery patients. Previous studies have shown that after LT, adjuvant chemotherapy such as the FOLFOX regimen for HCC significantly prolongs patients' survival (34)(35)(36). However, few studies have focused on the association of other chemotherapy regimens and LT; hence, more randomized controlled clinical trials are needed for further validation.…”

Section: Discussionmentioning

confidence: 99%

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

Zhang¹,

Jiang²,

Huang³

et al. 2022

Transl Cancer Res TCR

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Background: Hepatocellular carcinoma (HCC) is regarded as a high-mortality cancer, but the effectiveness of surgical strategies for young patients with early-stage HCC remains controversial. We aimed to analyze the survival in young patients with stage I-II HCC who underwent different kinds of surgical treatments. Methods: Overall survival (OS) and cancer-specific survival (CSS) were compared among patients aged 18-45 years with stage I-II HCC from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2013) who underwent local tumor destruction (LTD), wedge or segmental resection (WSR), lobectomy resection (LR), liver transplantation (LT), or non-surgery. Univariate and multivariate analyses and Kaplan-Meier method were used to examine the OS and CSS of the patients. A stratification analysis of CSS was also conducted among the subgroups.Results: Data from 664 patients were extracted. The median survival time was 46 months. In the multivariate analysis of OS, compared with non-surgery, LTD [hazard ratio (HR), 0.37; 95% confidence interval (CI): 0.25-0.54; P<0.0001], LR (HR, 0.29; 95% CI: 0.19-0.45; P<0.0001), and WSR (HR, 0.26; 95% CI: 0.17-0.39; P<0.0001) had better outcomes, and LT had the best survival benefit (HR, 0.24; 95% CI: 0.16-0.36; P<0.0001), which was similar to CSS. In the stratification analysis, compared with the nonsurgery group, among patients with chemotherapy, LT reduced the risk of CSS by 64% (HR, 0.36; 95% CI: 0.19-0.66; P interaction=0.0004).Conclusions: Surgery offers a survival benefit compared with non-surgery for young patients with stage I-II HCC. LT is associated with better survival than WSR, LR, and LTD.

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Section: Discussionmentioning

confidence: 99%

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

Zhang¹,

Jiang²,

Huang³

et al. 2022

Transl Cancer Res TCR

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“…Although the prognosis varies among treated patients, the rate of tumor recurrence is generally high [ 86 ]. Adjuvant therapy decreases the risk of recurrence and provides survival benefits after surgical HCC resection [ 87 ].…”

Section: Clinical and Preclinical Applicationsmentioning

confidence: 99%

mRNA-Based Approaches to Treating Liver Diseases

Cacicedo

Limeres

Gehring

2022

Cells

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Diseases that affect the liver account for approximately 2 million deaths worldwide each year. The increasing prevalence of these diseases and the limited efficacy of current treatments are expected to stimulate substantial growth in the global market for therapeutics that target the liver. Currently, liver transplantation is the only curative option available for many liver diseases. Gene therapy represents a valuable approach to treatment. The liver plays a central role in a myriad of essential metabolic functions, making it an attractive organ for gene therapy; hepatocytes comprise the most relevant target. To date, viral vectors constitute the preferred approach to targeting hepatocytes with genes of therapeutic interest. Alternatively, mRNA-based therapy offers a number of comparative advantages. Clinical and preclinical studies undertaken to treat inherited metabolic diseases affecting the liver, cirrhosis and fibrosis, hepatocellular carcinoma, hepatitis B, and cytomegalovirus using lipid nanoparticle-encapsulated mRNAs that encode the therapeutic or antigenic protein of interest are discussed.

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“…Moreover, the overall outcomes of these interventions are variable, and rendering the improvement of prognosis for these patients is a major challenge. 9 …”

Section: Introductionmentioning

confidence: 99%

Postoperative Adjuvant Hepatic Arterial Infusion Chemotherapy With FOLFOX in Hepatocellular Carcinoma With Microvascular Invasion: A Multicenter, Phase III, Randomized Study

Mei

Cheng

et al. 2023

JCO

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PURPOSE To report the efficacy and safety of postoperative adjuvant hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and oxaliplatin (FOLFOX) in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI). PATIENTS AND METHODS In this randomized, open-label, multicenter trial, histologically confirmed HCC patients with MVI were randomly assigned (1:1) to receive adjuvant FOLFOX-HAIC (treatment group) or routine follow-up (control group). The primary end point was disease-free survival (DFS) by intention-to-treat (ITT) analysis while secondary end points were overall survival, recurrence rate, and safety. RESULTS Between June 2016 and August 2021, a total of 315 patients (ITT population) at five centers were randomly assigned to the treatment group (n = 157) or the control group (n = 158). In the ITT population, the median DFS was 20.3 months (95% CI, 10.4 to 30.3) in the treatment group versus 10.0 months (95% CI, 6.8 to 13.2) in the control group (hazard ratio, 0.59; 95% CI, 0.43 to 0.81; P = .001). The overall survival rates at 1 year, 2 years, and 3 years were 93.8% (95% CI, 89.8 to 98.1), 86.4% (95% CI, 80.0 to 93.2), and 80.4% (95% CI, 71.9 to 89.9) for the treatment group and 92.0% (95% CI, 87.6 to 96.7), 86.0% (95% CI, 79.9 to 92.6), and 74.9% (95% CI, 65.5 to 85.7) for the control group (hazard ratio, 0.64; 95% CI, 0.36 to 1.14; P = .130), respectively. The recurrence rates were 40.1% (63/157) in the treatment group and 55.7% (88/158) in the control group. Majority of the adverse events were grade 0-1 (83.8%), with no treatment-related death in both groups. CONCLUSION Postoperative adjuvant HAIC with FOLFOX significantly improved the DFS benefits with acceptable toxicities in HCC patients with MVI.

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Comparative Effectiveness of Adjuvant Treatment for Resected Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis

Cited by 11 publications

References 62 publications

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

mRNA-Based Approaches to Treating Liver Diseases

Postoperative Adjuvant Hepatic Arterial Infusion Chemotherapy With FOLFOX in Hepatocellular Carcinoma With Microvascular Invasion: A Multicenter, Phase III, Randomized Study

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