Background: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. Aim: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. Methods: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. Results: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in patients undergoing m-Tor inhibitor therapy. The pooled estimate of 1-year survival was 63%. There was a significant heterogeneity among studies (. P<. 0.0001). Among the 34 variables assessed by univariate meta-regression, 5 were associated with an increase in the 1-year survival rate: (1) male gender (. P=. 0.001); (2) Time to progression (. P=. 0.038); and adverse drug events, divided in (3) gastrointestinal (. P=. 0.038), (4) cardiovascular (. P=. 0.029), and (5) dermatological (. P=. 0.014). Conclusions: Additional data from multicentre prospective studies are required to clearly determine if sorafenib is a safe and acceptable treatment in hepatocellular carcinoma recurrence after liver transplant. Nevertheless, its association with m-Tor inhibitors should be discouraged.

Mancuso A., Mazzola A., Cabibbo G., Perricone G., Enea M., Galvano A., et al. (2015). Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis. DIGESTIVE AND LIVER DISEASE, 47(4), 324-330 [10.1016/j.dld.2015.01.001].

Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis

Cabibbo G.;Enea M.;Galvano A.;Camma C.
2015

Abstract

Background: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. Aim: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. Methods: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. Results: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in patients undergoing m-Tor inhibitor therapy. The pooled estimate of 1-year survival was 63%. There was a significant heterogeneity among studies (. P<. 0.0001). Among the 34 variables assessed by univariate meta-regression, 5 were associated with an increase in the 1-year survival rate: (1) male gender (. P=. 0.001); (2) Time to progression (. P=. 0.038); and adverse drug events, divided in (3) gastrointestinal (. P=. 0.038), (4) cardiovascular (. P=. 0.029), and (5) dermatological (. P=. 0.014). Conclusions: Additional data from multicentre prospective studies are required to clearly determine if sorafenib is a safe and acceptable treatment in hepatocellular carcinoma recurrence after liver transplant. Nevertheless, its association with m-Tor inhibitors should be discouraged.
Mancuso A., Mazzola A., Cabibbo G., Perricone G., Enea M., Galvano A., et al. (2015). Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis. DIGESTIVE AND LIVER DISEASE, 47(4), 324-330 [10.1016/j.dld.2015.01.001].
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10447/412365
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