Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2015; 21(5): 1636-1640
Published online Feb 7, 2015. doi: 10.3748/wjg.v21.i5.1636
Peri-operative use of sorafenib in liver transplantation: A time-to-event meta-analysis
Hao-Long Qi, Bing-Jie Zhuang, Chang-Sheng Li, Quan-Yan Liu
Hao-Long Qi, Bing-Jie Zhuang, Chang-Sheng Li, Quan-Yan Liu, Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Qi HL and Zhuang BJ performed the information retrieval, screened the potential subjects, and extracted and integrated the data independently at the same time; Li CS and Liu QY designed the study and wrote the manuscript.
Supported by National Natural Science Foundation of China, No. 81172349 and No. 30872491.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Quan-Yan Liu, Professor, Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital, Wuhan University, No. 299 Ba Yi Road, Wuhan 430071, Hubei Province, China. 1459195529@qq.com
Telephone: +86-27-67812588 Fax: +86-27-87336735
Received: June 27, 2014
Peer-review started: June 28, 2014
First decision: July 21, 2014
Revised: August 9, 2014
Accepted: September 19, 2014
Article in press: September 19, 2014
Published online: February 7, 2015
Processing time: 227 Days and 4 Hours
Abstract

AIM: To evaluate whether the application of sorafenib during the peri-operative period of liver transplantation improves prognosis in liver cancer patients.

METHODS: We searched PubMed, EMBASE and MEDLINE for eligible articles. A total of 4 studies were found that fulfilled the previously agreed-upon standards. We then performed a systematic review and meta-analysis on the enrolled trials that met the inclusion criteria.

RESULTS: Out of the 104 studies identified in the database, 82 were not clinical experiments, and 18 did not fit the inclusion standards. Among the remaining 4 articles, only 1 was related to the preoperative use of sorafenib, whereas the other 3 were related to its postoperative use. As the heterogeneity among the 4 studies was high, with an I2 of 86%, a randomized effect model was applied to pool the data. The application of sorafenib before liver transplantation had a hazard ratio (HR) of 3.29 with a 95% confidence interval (CI) of 0.33-32.56. The use of sorafenib after liver transplantation had an HR of 1.44 (95%CI: 0.27-7.71). The overall pooled HR was 1.68 (95%CI: 0.41-6.91).

CONCLUSION: The results showed that the use of sorafenib during the peri-operative period of liver transplantation did not improve patient survival significantly. In fact, sorafenib could even lead to a worse prognosis, as its use may increase the hazard of poor survival.

Keywords: Liver transplantation; Sorafenib; Peri-operative period; Kaplan-Meier curve; Hazard ratio

Core tip: The data were extracted from the Kaplan-Meier curves of every study identified and then input into a hazard ratio calculation spreadsheet. The HRs generated from the sheet were combined with RevMan5.0. To the best of our knowledge, this is the first meta-analysis assessing the use of sorafenib in the peri-operative period of liver transplantation.