Hepatobiliary Surgery, Peking University People's Hospital.
Hepatobiliary Surgery, Peking University People's Hospital, China.
Rev Esp Enferm Dig. 2020 Mar;112(3):201-210. doi: 10.17235/reed.2020.6458/2019.
hepatocellular carcinoma (HCC) recurrence after liver resection remains a major threat for patients' survival. Sorafenib is recommended as an adjuvant treatment for patients after a liver resection. The objective of this meta-analysis was to estimate the therapeutic value of sorafenib in patients who underwent a HCC resection.
relevant reports were retrieved from electronic databases. All eligible studies were carefully reviewed and the required data were extracted. Outcome with regard to overall survival (OS), recurrence-free survival (RFS), recurrence rate, mortality rate, OS time (months) and RFS time (months) were analyzed.
nine trials were included. The results of the meta-analysis revealed that sorafenib did not exert a significant superior effect on OS (sorafenib as reference: hazard ratio [HR] = 2.15; 95% CI, 0.91-5.08, p = 0.80; control as reference: HR = 0.56; 95% CI, 0.31-1.02; p = 0.059), OS time in months (weighted mean differences [WMD] = 4.96; 95% CI, -1.21-11.13; p = 0.115) and RFS time in months (WMD = 7.58; 95% CI, -1.36-16.53; p = 0.097). Nevertheless, the use of sorafenib was associated with a significantly higher RFS (HR = 0.53; 95% CI, 0.31-0.90; p = 0.018), and a lower recurrence rate (risk ratio [RR] = 0.72; 95% CI, 0.60-0.86; p < 0.001) and mortality rate (RR = 0.74; 95% CI, 0.57-0.95; p = 0.20).
according to the present meta-analysis, sorafenib showed a significant benefit in RFS, recurrence rate and mortality rate. The effect of sorafenib for the prevention of HCC recurrence seems to be encouraging. However, more evidence is still needed before reaching a definitive conclusion.
肝癌(HCC)切除术后的复发仍然是患者生存的主要威胁。索拉非尼被推荐作为肝切除术后的辅助治疗。本荟萃分析的目的是评估索拉非尼在接受 HCC 切除术的患者中的治疗价值。
从电子数据库中检索相关报告。仔细审查所有合格的研究并提取所需数据。分析总生存(OS)、无复发生存(RFS)、复发率、死亡率、OS 时间(月)和 RFS 时间(月)等结局。
纳入 9 项试验。荟萃分析结果表明,索拉非尼在 OS 方面没有显著优势(以索拉非尼为参照:风险比[HR] = 2.15;95%CI,0.91-5.08,p = 0.80;以对照组为参照:HR = 0.56;95%CI,0.31-1.02;p = 0.059)、OS 时间(月)(加权均数差[WMD] = 4.96;95%CI,-1.21-11.13;p = 0.115)和 RFS 时间(月)(WMD = 7.58;95%CI,-1.36-16.53;p = 0.097)。然而,使用索拉非尼与 RFS 显著提高相关(HR = 0.53;95%CI,0.31-0.90;p = 0.018),复发率(风险比[RR] = 0.72;95%CI,0.60-0.86;p < 0.001)和死亡率(RR = 0.74;95%CI,0.57-0.95;p = 0.20)较低。
根据本荟萃分析,索拉非尼在 RFS、复发率和死亡率方面显示出显著获益。索拉非尼预防 HCC 复发的效果似乎令人鼓舞。然而,在得出明确结论之前,仍需要更多的证据。