Prevention of intrahepatic recurrence by adjuvant 131iodine-labeled lipiodol after resection for hepatocellular carcinoma in HCV-related cirrhosis

Adjuvant Intrahepatic Injection Iodine-131-Lipiodol Improves Prognosis of Patients with Hepatocellular Carcinoma After Resection: a Meta-Analysis

“…Seven studies that matched the selection criteria were retrieved from the electronic databases [11][12][13][14][17][18][19]. Of these studies, two studies was excluded due to overlap of author [11,12].…”

“…Of these studies, two studies was excluded due to overlap of author [11,12]. Finally, five articles, including two RCTs [14,17] and three case-control studies [13,18,19], were included in the meta-analysis. The characteristics of the five studies are shown in Table 1.…”

“…131 ILipiodol therapy have been proven to be a safe and effective palliative treatment of unresectable HCC [8][9][10]. However, studies on the role of adjuvant 131 I-lipiodol in preventing the recurrence of HCC have been relatively limited and have yielded conflicting results [11][12][13][14]. We accordingly conducted a meta-analysis to examine the effectiveness on the recurrence of HCC after resection of adjuvant intrahepatic injection of 131 I-lipiodol.…”

“…In the current study, the incidence of early recurrences was significantly lower in patients given adjuvant treatment, apparently because of microscopic tumour foci that have been proved to be a significant predictive factors of early recurrence. Tabone et al [13] found that the preventive effect of 131 I-lipiodol treatment on HCC recurrence was completely lost after 36 months when disease-free survival was similar to the control patients. Lau et al [17] reported that adjuvant 131 I-lipiodol therapy could not significantly decrease the intrahepatic recurrence rate (42.9 vs. 54.5 %, P=0.28) in the long-term follow-up (at 8 years after randomization).…”

“…Despite intrahepatic injection of 131 I-lipiodol is technically feasible, it requires a cumbersome logistic organization and the collaboration of different motivated specialists, such as surgeon, hepatologist, interventional radiologist, and nuclear medicine doctors. As a result, there are very only a few centres equipped to perform this treatment [13]. In addition, there is great heterogeneity among the trials in terms of the time interval of treatment from surgery and dosage of 131 Ilipiodol employed.…”