Conventional oral systemic chemotherapy for postoperative hepatocellular carcinoma: A systematic review

Zhong,Jianhong; Xiang,Bangde; Ma,Liang; Li,Lequn

doi:10.3892/mco.2014.337

Conventional oral systemic chemotherapy for postoperative hepatocellular carcinoma: A systematic review

Authors:
- Jianhong Zhong
- Bangde Xiang
- Liang Ma
- Lequn Li
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Affiliations: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
Published online on: July 7, 2014 https://doi.org/10.3892/mco.2014.337
Pages: 1091-1096

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Abstract

The findings of randomized clinical trials (RCTs) regarding the efficacy of adjuvant conventional oral systemic chemotherapy (COSC) for patients with hepatocellular carcinoma (HCC) following curative hepatic resection (HR) are contradictory. Therefore, a systematic review of RCTs is required to evaluate the clinical efficacy of adjuvant COSC. Sources such as Medline, Embase and the Cochrane Library were systematically searched and all the RCTs comparing curative HR alone to HR plus COSC for HCC were identified. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. No treatment‑related mortality was reported by the included RCTs and the adverse effects of COSC were generally mild. However, adjuvant COSC did not achieve a statistically significant improvement in the 1‑, 3‑ and 5‑year overall survival (OR=1.43, 95% CI: 0.58‑3.56, P=0.44; OR=1.39, 95% CI: 0.75‑2.55, P=0.29; and OR=1.20, 95% CI: 0.46‑3.16, P=0.71, respectively). In addition, adjuvant COSC did not achieve a statistically significant decrease in the incidence of 1‑, 3‑ and 5‑year tumor recurrence, with pooled ORs of 0.92 (95% CI: 0.26‑1.35, P=0.66); 0.82 (95% CI: 0.66‑1.01, P=0.06); and 0.84 (95% CI: 0.71‑1.01, P=0.06), respectively. Narrative reviews offer no evidence supporting the use of COSC. Adjuvant COSC has provided marginal benefits for HCC patients following curative HR. Considering the efficacy of sorafenib for advanced HCC and the results of this systematic review, no further trials should be performed to assess the efficacy of adjuvant COSC.

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