Locoregional Therapies for Hepatocellular Carcinoma

作者：Krishnan R. Patel, Hari Menon, Roshal R. Patel, Erich P. Huang, Vivek Verma, Freddy E. Escorcia · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.47995 · 被引用次数：46 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Cancer Research and Treatment

Importance: Several locoregional therapies (LRTs) for nonmetastatic hepatocellular carcinoma (HCC) are available; however, a global comparison of the relative efficacy of each is needed. Objective: To conduct a systematic review and direct, pairwise meta-analytic comparison of all identified randomized clinical trials evaluating the treatment of nonmetastatic HCC. Data Sources: A comprehensive search of PubMed and the proceedings of the American Society of Clinical Oncology and American Society for Radiation Oncology annual meetings from January 1, 2010, to November 1, 2023, was performed. Study Selection: Randomized clinical trials using a form of LRT (surgery with or without adjuvant therapy, radiofrequency ablation [RFA], microwave ablation [MWA], radiotherapy [RT], hepatic arterial infusion chemotherapy [HAIC], transarterial bland embolization [TAE], transarterial chemoembolization [TACE], or transarterial radioembolization [TARE]). Data Extraction and Synthesis: Study eligibility and data extraction were each reviewed by 2 authors independently. Random-effects meta-analyses were used to compare treatment categories. Main Outcomes and Measures: Progression-free survival (PFS) was the primary outcome; overall survival (OS) was the secondary outcome. Results: Forty randomized clinical trials reporting on comparative outcomes of 11 576 total patients with localized HCC treated with LRT were included. The median follow-up was 30.0 (IQR, 18.5-40.8) months. Direct pooled compar...