Conventional Oral Systemic Chemotherapy for Postoperative Hepatocellular Carcinoma
Keywords:Adjuvant, hepatocellular carcinoma, oral, systemic chemotherapy, systematic review.
Background:The findings of randomized clinical trials (RCTs) about the efficacy of adjuvant conventional oral systemic chemotherapy (COSC) for patients with hepatocellular carcinoma (HCC) after curative hepatic resection (HR) are contradictory. Therefore, a systematic review of clinical trials is needed to evaluate the clinical efficacy of adjuvant COSC.
Methods:Sources such as MEDLINE, EMBASE and the Cochrane Library were systematically searched.All clinical trials comparing curative HR with HR plus COSC for HCC were identified. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.
Results:Five RCTs and one non-RCT involving a total of 461 patients were included. No treatment-related deaths were reported in the including trials. The adverse effects of COSC were generally mild. However, included studies and meta-analysis showed that adjuvant COSC did not demonstrate statistically significant improvement for the 1-, 3-, and 5-year overall survival. For the 1-, 3-, and 5-year tumor recurrence and recurrence-free survival rates, adjuvant COSC also did not show statistically significant less incidence.
Conclusion:Adjuvant COSC provides no survival benefits for HCC patients after curative HR. Considering the efficacy of sorafenib for advanced HCC and the results of this systematic review, no more trials should be carried out to explore the efficacy of adjuvant COSC.
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