The treatment strategy of hepatocellular carcinoma applied following scientific guidelines is only supported by 77 randomized controlled trials published so far.
Figures clearly pinpoint hepatocellular carcinoma as an 'orphan' cancer in terms of clinical research versus other high-prevalent cancers worldwide.
A previous systematic review analyzed 61 randomized controlled trials from 1978 to 2002.
The review showed a modest survival benefit from chemoembolization in patients with intermediate tumors.
A lack of an effective first-line treatment option for patients with advanced disease was also noted.
The conclusions of the previous review have been endorsed by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases.
Dr Lopez and colleagues from Spain updated this evidence-based approach.
The research team included 16 randomized controlled trials published from 2002 to 2005.
|4 trials show better local cancer control in tumors larger than 2cm|
|Alimentary Pharmacology & Therapeutics|
The included trials assessed percutaneous ablation, other loco-regional therapies, and systemic therapies.
Of these trials, 8 showed high-quality methodological profiles.
The team found that 4 randomized controlled trials demonstrated a better local hepatocellular carcinoma control in tumors larger than 2cm.
The team observed that the tumors were treated by radiofrequency ablation compared with ethanol injection.
Dr Lopez' team commented, “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.”