Hepatocellular carcinoma: resection with adjuvant hepatic artery infusion therapy vs resection alone. A systematic review and meta‐analysis

Moran, Alexandra; Ramos, Lorena Flor; Picado, Omar; Pendola, Fiorella; Sleeman, Danny; Dudeja, Vikas; Merchant, Nipun B.; Yakoub, Danny

doi:10.1002/jso.25338

Cited by 18 publications

(10 citation statements)

References 31 publications

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“…It is also increasingly recognised that intratumoural injection of immunotherapy can lead not just to local priming, but can also have abscopal effects on distant tumours. 22 Conversely, in other clinical scenarios such as treatment of liver metastases, 23 isolated limb sarcomas, 24 and other cases, the clinician might use anticancer agents with the deliberate aim of obtaining a local/ regional, rather than systemic, effect. The development of radiopharmaceuticals such as radioactive iodine-131, 177Ludotatate and yttrium-90 has, to an extent, also blurred the margins between systemic therapy and radiotherapy.…”

Section: A Proposed Systematic and Comprehensive Framework To Determine Lot Terminology And Definitionsmentioning

confidence: 99%

Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework

Saini

Twelves

2021

Br J Cancer

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The complexity of neoplasia and its treatment are a challenge to the formulation of general criteria that are applicable across solid cancers. Determining the number of prior lines of therapy (LoT) is critically important for optimising future treatment, conducting medication audits, and assessing eligibility for clinical trial enrolment. Currently, however, no accepted set of criteria or definitions exists to enumerate LoT. In this article, we seek to open a dialogue to address this challenge by proposing a systematic and comprehensive framework to determine LoT uniformly across solid malignancies. First, key terms, including LoT and ‘clinical progression of disease’ are defined. Next, we clarify which therapies should be assigned a LoT, and why. Finally, we propose reporting LoT in a novel and standardised format as LoT N (CLoT + PLoT), where CLoT is the number of systemic anti-cancer therapies (SACT) administered with curative intent and/or in the early setting, PLoT is the number of SACT given with palliative intent and/or in the advanced setting, and N is the sum of CLoT and PLoT. As a next step, the cancer research community should develop and adopt standardised guidelines for enumerating LoT in a uniform manner.

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Section: A Proposed Systematic and Comprehensive Framework To Determine Lot Terminology And Definitionsmentioning

confidence: 99%

Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework

Saini

Twelves

2021

Br J Cancer

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“…But the anti-recurrence efficacy of most of the strategies has not been recognized universally, except for antiviral therapy ( 4 ). Hepatic artery infusion therapy (HAIT) followed by surgery has been confirmed in a meta-analysis to improve the overall survival (OS) and disease-free survival (DFS) of patients not candidates for transplantation ( 6 ). Hepatic artery infusion chemotherapy (HAIC), as a modality of HAIT, is first reported in 1962, but it has been flourishing in the recent decade due to the intensive chemotherapy regimen, such as FP (fluorouracil and cisplatin) and FOLFOX (fluorouracil, leucovorin, and oxaliplatin) ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Wang

Wei

et al. 2021

Front. Oncol.

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BackgroundTo systematically identify the long-term efficacy of postoperative adjuvant hepatic artery infusion chemotherapy (HAIC) for patients with hepatocellular carcinoma (HCC).MethodsPubMed, MedLine, Embase, the Cochrane Library, and Web of Science were searched to collect the eligible studies up to March 31, 2021, that compared the surgical resection (SR) versus SR+HAIC for HCC patients. The endpoints were overall survival (OS) rates and disease-free survival (DFS) rates, and the effect size was determined by hazard ratio (HR) with 95% CI.ResultsA total of 12 studies (two randomized controlled trials (RCTs) and 10 non-RCTs) including 1,333 patients were eligible for this meta-analysis. The pooled results showed that OS and DFS rates in the SR+HAIC group were both better than those in the SR alone group (HR = 0.56, 95% CI = 0.41–0.77, p < 0.001; HR = 0.66, 95% CI = 0.55–0.78, p < 0.001, respectively). Furthermore, the subgroup analysis showed that patients would benefit from SR+HAIC regardless of chemotherapy regimens and courses (all p < 0.05), and patients with microvascular or macrovascular invasion would also benefit more from SR+HAIC in terms of OS and DFS (all p < 0.05).ConclusionPostoperative adjuvant HAIC could improve the long-term prognosis of HCC patients, especially for those with microvascular or macrovascular invasion, regardless of chemotherapy regimens and courses, but it deserves further validation.

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“…Because of the small number of included studies in the subgroup, we considered that the results need be viewed with caution. Compared with systematic chemotherapy, intra-arterial chemotherapy had a higher local concentration of the chemotherapeutic agent in the target hepatic tissue and could yield residual micrometastases or tumor cells with less systematic toxicity [12,34]. Nevertheless, vascular endothelial growth factor was released from the tumor tissue due to hypoxia caused by intra-arterial embolization, which had a potential effect on local recurrence [35].…”

Section: Discussionmentioning

confidence: 99%

Adjuvant Transarterial Chemoembolization for Patients with Intrahepatic Cholangiocarcinoma after Surgical Resection: A Systematic Review and Meta-analysis

Wang

Wen

Zhuang³

et al. 2022

JGLD

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Aim: To investigate the efficacy of postoperative adjuvant transarterial chemoembolization (TACE) in patients with intrahepatic cholangiocarcinoma (ICC) after resection. Methods: Studies were systematically searched until August 2021 in the following databases: MEDLINE, EMBASE, PUBMED, Web of Science, Cochrane Library, Science Direct, and Springer Link. Overall survival (OS) and recurrence-free survival (RFS) were considered as the main outcomes. Pooled hazard ratio (HR) with 95% confidence interval (95%CI) was reported as results for the survival data. Subgroup analysis was conducted on the outcomes stratified by early-stage ICC and intra-arterial chemotherapeutic regimen. Results: Eleven studies with 2,757 patients were finally included in the study. The pooled HR of OS was 0.68 (95%CI: 0.50-0.87, I 2 =83.7%). The pooled HR of RFS was 1.00 (95%CI: 0.69-1.31, I 2 =88%). Receipt of postoperative adjuvant TACE improved the OS in the early-stage ICC subgroup (HR=0.68, 95%CI: 0.50-0.86, I 2 =54%). Addition of carboplatin could slightly improve the OS (HR=0.6, 95%CI: 0.35-0.85, I 2 =48%). But receipt of postoperative adjuvant TACE (HR=1.06, 95%CI: 0.83-1.29, I 2 =41.2%) or use of carboplatin (HR=1.30, 95%CI: 0.93-1.67, I 2 =0%) caused no significant improvement in the RFS in the early-stage ICC subgroup. Conclusions: Postoperative adjuvant TACE could improve the OS in ICC patients after hepatectomy but could not prevent late recurrence. Survival benefit was also found in early-stage ICC patients undergoing postoperative adjuvant TACE after hepatectomy. Addition or non-addition of carboplatin in chemoembolization showed a similar OS outcome.

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Hepatocellular carcinoma: resection with adjuvant hepatic artery infusion therapy vs resection alone. A systematic review and meta‐analysis

Cited by 18 publications

References 31 publications

Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework

Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework

Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Adjuvant Transarterial Chemoembolization for Patients with Intrahepatic Cholangiocarcinoma after Surgical Resection: A Systematic Review and Meta-analysis

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