Management of hepatocellular carcinoma: an overview of major findings from meta-analyses

Qi, Xingshun; Zhao, Yan; Li, Hongyu; Guo, Xiaozhong; Han, Guohong

doi:10.18632/oncotarget.9157

Cited by 59 publications

(43 citation statements)

References 136 publications

(347 reference statements)

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“…Despite the major advances achieved in the diagnostic workup of HCC, only one third of the newly diagnosed patients are presently eligible for curative treatments [3]. Even in the curative setting, 5-year survival rates after resection for early-stage HCC ranges between 17% and 53%, and recurrence rates can be as high as 70% [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications

et al. 2016

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HCC represents the sixth most common cancer worldwide and the second leading cause of cancer-related death. Despite the high incidence, treatment options for advanced HCC remain limited and unsuccessful, resulting in a poor prognosis. Despite the major advances achieved in the diagnostic management of HCC, only one third of the newly diagnosed patients are presently eligible for curative treatments. Advances in technology and an increased understanding of HCC biology have led to the discovery of novel biomarkers. Improving our knowledge about serum and tissutal markers could ultimately lead to an early diagnosis and better and early treatment strategies for this deadly disease. Serum biomarkers are striking potential tools for surveillance and early diagnosis of HCC thanks to the non-invasive, objective, and reproducible assessments they potentially enable. To date, many biomarkers have been proposed in the diagnosis of HCC. Cholangiocarcinoma (CCA) is an aggressive malignancy, characterized by early lymph node involvement and distant metastasis, with 5-year survival rates of 5%-10%. The identification of new biomarkers with diagnostic, prognostic or predictive value is especially important as resection (by surgery or combined with a liver transplant) has shown promising results and novel therapies are emerging. However, the relatively low incidence of CCA, high frequency of co-existing cholestasis or cholangitis (primary sclerosing cholangitis –PSC- above all), and difficulties with obtaining adequate samples, despite advances in sampling techniques and in endoscopic visualization of the bile ducts, have complicated the search for accurate biomarkers. In this review, we attempt to analyze the existing literature on this argument.

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Section: Introductionmentioning

confidence: 99%

Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications

et al. 2016

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“…With the application of polyvinyl alcohol, trisacryl gelatin microspheres (embospheres; Merit Medical Systems, Inc., South Jordan, UT, USA) and drug‐eluting beads, the common iodized oil TACE technique has been challenged by one that uses microspheres for the treatment of liver tumors . A recent large overview analyzed three meta‐analyses of TACE vs TAE; none of them found any significant difference between the two techniques . However, another study found that, compared to TAE, TACE significantly prolonged progression‐free survival (PFS) and time to progression (TTP), but not overall survival (OS) .…”

Section: Introductionmentioning

confidence: 99%

“…9,10 A recent large overview analyzed three meta-analyses of TACE vs TAE; none of them found any significant difference between the two techniques. 5 However, another study found that, compared to TAE, TACE significantly prolonged progression-free survival (PFS) and time to progression (TTP), but not overall survival (OS). 11 Thus, though TAE is reported to be efficacious, the ultimate outcome with TACE is better.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma

Hao

Lin

Chen

et al. 2017

J of Digest Diseases

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OBJECTIVE:To investigate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with embospheres for the treatment of unresectable hepatocellular carcinoma (HCC). METHODS:Patients with unresectable HCC who were treated with TACE followed by embosphere treatment (Embo-TACE) or conventional TACE (cTACE) between May 2010 and March 2014 were retrospectively included in this study. The Embo-TACE group received lipiodol and chemotherapeutic agent emulsion, followed by embospheres. The cTACE group received lipiodol and chemotherapeutic agent emulsion, followed by gelatin sponge pellets. Time to progression (TTP), overall survival (OS), overall response rate (ORR), and safety were compared between the two groups. Univariate and multivariate regression analyses of the factors affecting survival were conducted. RESULTS:The median TTP and OS in the Embo-TACE group were significantly longer than those in the cTACE group (TPP: 7.0 months vs 5.4 months, P = 0.035; OS: 15 months vs 12 months, P = 0.032). Seven days after the first TACE treatment, alanine aminotransferase level was higher in the cTACE group than in the Embo-TACE group (P = 0.015). The ORR did not significantly differ between the two groups (P = 0.827). Additional therapy and local responses one month after the first TACE treatment were associated with OS. CONCLUSIONS:Embo-TACE resulted in a significant improvement in TTP and OS for patients with unresectable HCC, compared with cTACE. Furthermore, Embo-TACE was better tolerated. Additional therapy and local responses one month after the first TACE were independent prognostic factors for OS.

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“…Grade of recommendation was determined in the way that was suggested by a previous study [64]. High grade recommendation was considered if the results of meta-analyses were based on more than 3 single-center RCTs or 1 multi-center RCT.…”

Section: Methodsmentioning

confidence: 99%

Management of advanced gastric cancer: An overview of major findings from meta-analysis

Liu

Wang

et al. 2016

Oncotarget

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This study aims to provide an overview of different treatment for advanced gastric cancer. In the present study, we systematically reviewed the major findings from relevant meta-analyses. A total of 54 relevant papers were searched via the PubMed, Web of Science, and Google scholar databases. They were classified according to the mainstay treatment modalities such as surgery, chemotherapy and others. Primary outcomes including overall survival, response rate, disease-free survival, recurrence-free survival, progression-free survival, time-to-progression, time-to failure, recurrence and safety were summarized. The recommendations and uncertainties regarding the treatment of advanced gastric cancer were also proposed. It was suggested that laparoscopic gastrectomy was a safe and technical alternative to open gastrectomy. Besides, neoadjuvant chemotherapy and adjuvant chemotherapy were thought to benefit the survival over surgery alone. And it was demonstrated in the study that targeted therapy like anti-angiogenic and anti-HER2 agents but anti-EGFR agent might have a significant survival benefit.

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Management of hepatocellular carcinoma: an overview of major findings from meta-analyses

Cited by 59 publications

References 136 publications

Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications

Serum and tissue markers in hepatocellular carcinoma and cholangiocarcinoma: clinical and prognostic implications

Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma

Management of advanced gastric cancer: An overview of major findings from meta-analysis

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