Efficacy of sorafenib in patients with hepatocellular carcinoma after resection: a meta-analysis

// Jin Shang 1, * , Shanling Xu 2, * , Jiaxing Zhang 3 , Xuting Ran 4 , Lang Bai 1 and Hong Tang 1 1 Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China 2 Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China 3 Chinese Evidence-based Medicine Center, Sichuan University, Chengdu, China 4 West China Medical School, Sichuan University, Chengdu, Sichuan, China * These authors contributed equally to this work and share Co-first authors Correspondence to: Lang Bai, email: pangbailang@163.com Keywords: hepatocellular carcinoma, liver resection, sorafenib, overall survival, recurrence Received: January 12, 2017      Accepted: September 13, 2017      Published: September 28, 2017 ABSTRACT Background: The prognosis of hepatocellular carcinoma remains poor even after curative resection and it has no effective adjuvant therapy. Aim: This meta-analysis aimed to assess efficacy of sorafenib as adjuvant therapy for patients with hepatocellular carcinoma after resection. Materials and methods: A systematic search was conducted of Medline, Embase, Web of Science, Cochrane Library, Chinese Wanfang database, Chinese biological and medical database, China National Knowledgeand the Internet, data from 5 studies that included 296 participants were analyzed. The primary outcome was overall survival. Secondary outcomes included recurrence rate and mortality rate. Results: In the comparison of sorafenib versus control, no significant difference in overall survival (hazard ratio 1.39, 95% confidence interval [CI] 0.71–2.74, P = 0.34) or recurrence rate [risk ratio (RR) 0.81, 95% CI; 0.65–1.01, P = 0.06) was found. For mortality rate, subgroup analysis was conducted according to study type, only in subgroup 2, the RR was significantly reduced (0.66, 95% CI; 0.51–0.87, P = 0.003) in studies. Conclusions: In this meta-analysis, sorafenib achieves no significant benefit in any of the endpoints except a lower mortality rate in subgroup analysis, indicating that there is no convincing evidence of sorafenib as an effective adjuvant therapy in patients with hepatocellular carcinoma after resection.