The role of vitamin K in the prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09

The role of vitamin K in the prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis

Guo et al., 2026 | Front Oncol | Systematic Review

Citation

Guo Lang, Wang Yaqiong, ... Huang Hai. The role of vitamin K in the prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis. Front Oncol. 2026;16:1765445. doi:10.3389/fonc.2026.1765445

Abstract

OBJECTIVE: This meta-analysis aimed to evaluate the influence of vitamin K (VK) as an adjunctive therapy on the prognosis of patients with hepatocellular carcinoma (HCC), with a specific focus on its clinical value in non-resected individuals. METHODS: We systematically retrieved Chinese and English databases, including PubMed and Embase, to select randomized controlled trials (RCTs) and cohort studies comparing VK combined with standard therapy versus standard therapy alone. Methodological quality was evaluated via the Newcastle-Ottawa Scale for cohort studies and the Cochrane Risk of Bias tool (RoB-2) for RCTs. The primary endpoints were overall survival (OS) and progression-free survival (PFS). The secondary endpoint was recurrence risk. Pooled hazard ratios (HRs) and relative risks (RRs) were computed by fixed- or random-effects models. Subgroup analyses (surgery vs. transarterial chemoembolization [TACE]) and time stratification (12-48M) were conducted to explore heterogeneity sources. RESULTS: Eleven studies involving 688 subjects were incorporated. The fixed-effects meta-analysis indicated that VK combined with standard therapy did not significantly improve OS (pooled HR = 0.77, 95% CI: 0.58-1.01). However, this combination prolonged PFS (pooled HR = 0.62, 95% CI: 0.47-0.82). Subgroup analysis based on PFS demonstrated more pronounced benefit in TACE-treated subjects (HR = 0.51, 95% CI: 0.34-0.77). Furthermore, VK combined with standard therapy reduced recurrence risk (pooled HR = 0.26, 95% CI: 0.15-0.46). CONCLUSION: Adjunctive VK improves PFS and reduces recurrence risk in HCC subjects, demonstrating particular benefit for those with unresectable tumors receiving TACE. No significant OS advantage was observed. Future investigations should optimize VK dosing and administration strategies and explore its potential synergy with immunotherapy. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251106693, identifier CRD420251106693.

Key Findings

Eleven studies involving 688 subjects were incorporated. The fixed-effects meta-analysis indicated that VK combined with standard therapy did not significantly improve OS (pooled HR = 0.77, 95% CI: 0.58-1.01). However, this combination prolonged PFS (pooled HR = 0.62, 95% CI: 0.47-0.82). Subgroup analysis based on PFS demonstrated more pronounced benefit in TACE-treated subjects (HR = 0.51, 95% CI: 0.34-0.77). Furthermore, VK combined with standard therapy reduced recurrence risk (pooled HR = 0.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population hepatocellular carcinoma
Sample Size 688
Age Range See abstract
Condition See abstract

MeSH Terms

  • No MeSH terms indexed

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: vitamin-k-cancer

Provenance

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