Systematic review and meta-analysis of adjuvant i(131) lipiodol after excision of hepatocellular carcinoma

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#carcinoma-hepatocellular #case-control-studies #chemotherapy-adjuvant #combined-modality-therapy #ethiodized-oil

Systematic review and meta-analysis of adjuvant i(131) lipiodol after excision of hepatocellular carcinoma

Furtado et al., 2014 | Ann Surg Oncol | Meta Analysis

Citation

Furtado Ruelan, Crawford Michael, Sandroussi Charbel. Systematic review and meta-analysis of adjuvant i(131) lipiodol after excision of hepatocellular carcinoma. Ann Surg Oncol. 2014-Aug;21(8):2700-7. doi:10.1245/s10434-014-3511-2

Abstract

BACKGROUND: Curative resection for hepatocellular carcinoma (HCC) has an 80 % recurrence at 5 years. Survival could be prolonged with adjuvant iodine(131) lipiodol. This systematic review and meta-analysis was designed to assess the survival benefit of this treatment in patients with resected HCC compared with surgery alone. METHODS: Studies were identified through a systematic search of MEDLINE, EMBASE, PubMed, and Cochrane databases in June 2013. Three case-control series and two randomized, controlled trials (RCT) were included. Two of these studies had a second publication that analyzed long-term follow-up. Two reviewers extracted data with respect to disease-free and overall survival (OS). The data from the seven studies was then subject to meta-analysis. RESULTS: Age, sex, liver function, tumor size, encapsulation, microvascular invasion, multifocality, and the rate of major hepatic resection were similar in the two groups. Peto odds ratio for disease-free survival was 0.47 (95 % confidence interval (CI) 0.37-0.59, I (2 )= 10 %) and for OS was 0.5 (95 % CI 0.39-0.64, I (2 )= 37 %), in favor of treatment. CONCLUSIONS: This study is limited by its comparison of two RCTs with three case-control studies. Most patients also had preserved liver function, and there was a generally low rate of microvascular invasion. Nonetheless, there is strong evidence for the use of adjuvant I(131) lipiodol, to prolong disease-free and OS, up to 5 years after resection.

Key Findings

Age, sex, liver function, tumor size, encapsulation, microvascular invasion, multifocality, and the rate of major hepatic resection were similar in the two groups. Peto odds ratio for disease-free survival was 0.47 (95 % confidence interval (CI) 0.37-0.59, I (2 )= 10 %) and for OS was 0.5 (95 % CI 0.39-0.64, I (2 )= 37 %), in favor of treatment.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population resected hcc compared with
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Carcinoma, Hepatocellular
  • Case-Control Studies
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Ethiodized Oil
  • Hepatectomy
  • Humans
  • Iodine Radioisotopes
  • Liver Neoplasms
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Survival Rate

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09