Systematic review: evidence‐based management of hepatocellular carcinoma–an updated analysis of randomized controlled trials
PM Lopez, A Villanueva… - Alimentary pharmacology & …, 2006 - Wiley Online Library
PM Lopez, A Villanueva, JM Llovet
Alimentary pharmacology & therapeutics, 2006•Wiley Online LibraryThe treatment strategy of hepatocellular carcinoma applied following scientific guidelines is
only supported by 77 randomized controlled trials published so far, a figure that clearly
pinpoints hepatocellular carcinoma as an 'orphan'cancer in terms of clinical research when
compared with other high‐prevalent cancers worldwide. A systematic review analysing 61
randomized controlled trials (1978–2002) showed a modest survival benefit from
chemoembolization in patients with intermediate tumours, and the lack of an effective first …
only supported by 77 randomized controlled trials published so far, a figure that clearly
pinpoints hepatocellular carcinoma as an 'orphan'cancer in terms of clinical research when
compared with other high‐prevalent cancers worldwide. A systematic review analysing 61
randomized controlled trials (1978–2002) showed a modest survival benefit from
chemoembolization in patients with intermediate tumours, and the lack of an effective first …
Summary
The treatment strategy of hepatocellular carcinoma applied following scientific guidelines is only supported by 77 randomized controlled trials published so far, a figure that clearly pinpoints hepatocellular carcinoma as an ‘orphan’ cancer in terms of clinical research when compared with other high‐prevalent cancers worldwide.
A systematic review analysing 61 randomized controlled trials (1978–2002) showed a modest survival benefit from chemoembolization in patients with intermediate tumours, and the lack of an effective first‐line treatment option for patients with advanced disease. These conclusions have been endorsed by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases.
The present updated evidence‐based approach includes 16 randomized controlled trials published from 2002 to 2005 assessing percutaneous ablation (seven), other loco‐regional therapies (three) and systemic therapies (six). Eight showed high‐quality methodological profiles.
Four randomized controlled trials demonstrated a better local hepatocellular carcinoma control in tumours larger than 2 cm treated by radiofrequency ablation compared with ethanol injection. No survival advantages were obtained from systemic treatments in patients with advanced hepatocellular carcinoma, an area that is an unmet need. Therefore, there is an urgent request to conduct well‐designed phase III investigations in hepatocellular carcinoma patients.
Wiley Online Library