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Meta-analysis: recurrence and survival following the use of sirolimus... » Isaúde
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Alimentary Pharmacology and Therapeutics
2012-12-21 01:46:15

Meta-analysis: recurrence and survival following the use of sirolimus in liver transplantation for hepatocellular carcinoma

Descrição: BackgroundThe use of sirolimus (SRL)-based immunosuppression protocols have been reported to reduce recurrence rates following liver transplantation (LT) for hepatocellular carcinoma (HCC), although this is still a matter for debate.AimTo undertake a systematic review and meta-analysis of available literature on the usage of SRL as an immunosuppressive agent following LT for HCC, with a view to comparing cancer outcomes with the commonly used calcineurin inhibitors (CNIs).MethodsSystematic review and meta-analysis carried out in line with the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Primary outcomes of interest were tumour recurrence rate and recurrence-free survival (RFS). Secondary outcomes were recurrence-related mortality and overall survival (OS).ResultsIn all, 5 studies met the inclusion criteria (n?=?474). The recurrence rate was lower in SRL group (4.9-12.9%) in comparison with CNIs (17.3-38.7%). The 1-, 3- and 5-year RFS was 93-96%, 82-86% and 79-80% for SRL group, which was much better in comparison with the CNIs 70-78%, 64-65% and 54-60% respectively. Similarly, 1-, 3- and 5-year OS was much better for SRL group (94-95%, 85% and 80%) in comparison with CNIs (79-83%, 66% and 59-62%) respectively. Meta-analysis demonstrated lower recurrence (OR?=?0.30, 95% CI?=?0.16-0.55, P?

Editorial: John Wiley & Sons, Inc.
Seção: Meta-analysis
Volume: 0
Página: 411 a 419


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