Home > DARE Reviews > Systematic review: evidence-based...
  • We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Systematic review: evidence-based management of hepatocellular carcinoma. An updated analysis of randomized controlled trials

Review published: 2006.

Bibliographic details: Lopez P M, Villanueva A, Llovet J M.  Systematic review: evidence-based management of hepatocellular carcinoma. An updated analysis of randomized controlled trials. Alimentary Pharmacology and Therapeutics 2006; 23(11): 1535-1547. [PubMed: 16696801]

Quality assessment

The review assessed treatments for hepatocellular cancer published in recent randomised trials. There is evidence of lower recurrence with radiofrequency ablation compared with percutaneous ethanol injection, but no benefit in survival. Systemic treatments do not seem to significantly improve survival. Doubt about whether all relevant studies were included in the review casts some uncertainty on the conclusions. Full critical summary

Abstract

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.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2012 University of York.

PubMed Health Blog...

read all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...