Comparative effectiveness of several adjuvant therapies after hepatectomy for hepatocellular carcinoma patients with microvascular invasion

Table 1 Literature search criteria

Database	Literature search criteria	Number of literatures
PubMed	((microvascular invasion) OR MVI) AND ((“Carcinoma, Hepatocellular”[Mesh]) OR (hepatocellular carcinoma[Title/Abstract]) OR (liver cancer[Title/Abstract]) OR (hepatoma[Title/Abstract])) AND (resection[Title/Abstract] OR hepatectomy[Title/Abstract]) AND (post-operative[Title/Abstract] OR postoperative[Title/Abstract] OR adjuvant[Title/Abstract] OR prevent[Title/Abstract])	300
Web of Science	(TS = (hepatocellular carcinoma)) AND ((AB = (resection OR hepatectomy)) OR TI = (resection OR hepatectomy)) AND ((TI = (post-operative OR postoperative OR adjuvant OR prevent)) OR AB = (post-operative OR postoperative OR adjuvant OR prevent)) AND ((TI = (microvascular invasion)) OR AB = (microvascular invasion))	250
EMBASE	‘hepatocellular carcinoma’/exp AND (‘resection’/exp OR ‘hepatectomy’/exp) AND (‘adjuvant’/exp OR ‘postoperative’ OR ‘post-operative’ OR prevent:ti OR prevention:ti) AND ‘microvascular invasion’/exp	68

Table 2 The baseline characteristics of included studies

Ref.	Design	Enrollment period	Treatment	Sample size (n)	Male (n)	Age (yr)	Tumor size (cm)	Multiple nodules (n)	HBV (n)	Child-Pugh, A/B (n)
Li et al[8], 2021	Retrospective cohort, PSM	August 2009 to August 2017	Sorafenib	42	34/8	54.2 ± 1.4	6.2 ± 0.6	29	NA	42
			HT alone	42	35/7	54.6 ± 1.7	7.2 ± 0.8	25	NA	42
Zhang et al[17], 2019	Retrospective cohort, PSM	2009 to 2016	Sorafenib	113	97/16	49.0 (43.0-56.0)	5.9 (4.0-9.0)	17	102	111/2
			HT alone	113	98/15	48.0 (40.0-57.0)	5.42 (3.8-9.1)	21	98	112/1
Huang et al[18], 2019	Retrospective cohort	January 2009 to December 2016	Sorafenib	16	12	52.25 ± 11.94	NA	2	12	16/0
			HT alone	33	30	51.52 ± 11.87	NA	3	26	31/2
Li et al[9], 2023	RCT	June 2016 to August 2021	HAIC	143	122	51 (25-75)	5.5 (1.8-30.0)	43	125	142/1
			HT alone	143	126	54 (27-75	5.4 (1.5-16.0)	27	51	141/2
Hsiao et al[19], 2017	Retrospective cohort	2006 to 2014	HAIC	29	NA	NA	NA	NA	NA	NA
			HT alone	41	NA	NA	NA	NA	NA	NA
Shi et al[20], 2022	RCT	August 2015 to December 2016	RT	38	33	56.42 ± 10.44	4.87 ± 2.03	NA	36	NA
			HT alone	38	32	55.74 ± 10.19	4.88 ± 2.46	NA	36	NA
Wang et al[10], 2020	Retrospective cohort	July 2015 to December 2018	RT	29	24	55.90 ± 8.05	4.75 ± 2.15	2	29	29/0
			HT alone	30	25	56.57 ± 9.43	4.50 ± 2.98	2	30	30/0
Wang et al[21], 2019	Retrospective cohort, PSM	July 2008 to December 2016	RT	46	43	50.98 ± 10.53	5.39 ± 2.74	4	38	46/0
			TACE	46	37	51.52 ± 11.40	5.50 ± 3.07	5	36	46/0
Qiu et al[22], 2022	Retrospective cohort, PSM	April 2014 to July 2019	TACE	164	138	51 ± 12	4.7 ± 2.9	43	135	162/2
			HT alone	164	145	52 ± 12	5.0 ± 2.9	52	136	162/2
Wang et al[23], 2019	Retrospective cohort, PSM	September 2004 to December 2015	TAEC	57	47	55 ± 11	6 (2-14)	11	47/2	54/3
			HT alone	57	51	56 ± 10	6 (2-18)	11	47/6	54/3
Qi et al[24], 2019	Prospective cohort	January 2012 to December 2014	TACE	91	78	NA	NA	23	77	54/37
			HT alone	109	93	NA	NA	25	96	76/33
Wei et al[7], 2018	RCT	June 2009 to December 2012	TACE	116	106	44.0 (18-75)	5	0	94/NA	116/0
			HT alone	118	106	48.5 (18-74)	5	0	101/NA	116/2
Wang et al[25], 2018	Retrospective cohort	January 2010 to December 2014	TACE	44	42	52.07 ± 7.24	3.84 ± 1.27	44	NA	41/1
			HT alone	84	76	54.49 ± 10.18	3.83 ± 1.09	84	NA	82/2
Sun et al[26], 2016	Retrospective cohort	January 2004 to June 2013	TACE	137	120	48.88 ± 0.87	6.51 ± 0.27	11	121	135/2
			HT alone	185	167	49.91 ± 0.72	6.99 ± 0.29	17	163	182/3

PSM: Propensity score matching; RCT: Randomized controlled trial; HT: Hepatectomy; HAIC: Hepatic artery infusion chemotherapy; RT: Radiotherapy; TACE: Transarterial chemoembolization; NA: Not available; HBV: Hepatitis B virus.

Table 3 Methodological quality assessment for cohort studies using the Newcastle-Ottawa Scale

Ref.	Selection				Comparability	Exposure			Quality Score
	Representativeness of the exposed cohort	Selection of the non-exposed cohort	Ascertainment of exposure	Demonstration that outcome of interest was not present at start of study	Comparability of cohorts on the basis of the design or analysis	Assessment of outcome	Was follow-up long enough for outcomes to occur	Adequacy of follow up of cohorts
Li et al[8], 2021	1	1	1		2	1	1		7
Zhang 2019	1	1	1	1	2	1	1		8
Huang et al[18], 2019	1	1	1		2	1	1	1	8
Hsiao et al[19], 2017	1	1	1	1	1	1	1		7
Wang et al[10], 2020	1	1	1		2	1	1		7
Wang et al[21], 2019	1	1	1		1	1	1		6
Qiu et al[22], 2022	1	1	1		1	1	1	1	7
Wang et al[23], 2019	1	1	1		2	1	1		7
Qi et al[24], 2019	1	1	1		2	1	1		7
Wang et al[25], 2018	1	1	1		1	1	1	1	7
Sun et al[26], 2016	1	1	1		1	1	1		6

Table 4 Comparisons of the fit of consistency and inconsistency

Model	Recurrence free survival	Overall survival
Consistency	18.00	20.25
Inconsistency	19.79	21.82