Meta‐analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma

Summary Aim : To evaluate adjuvant modalities after curative resection for hepatocellular carcinoma using a meta‐analysis of randomized and non‐randomized controlled trials. Methods : In a first step, a meta‐analysis of randomized controlled trials was carried out. Sensitivity analyses after inclusion of non‐randomized controlled trials were performed. Four therapeutic modalities were evaluated: pre‐operative transarterial chemotherapy, post‐operative transarterial chemotherapy, systemic chemotherapy and a combination of systemic and transarterial chemotherapy. Results : Only post‐operative transarterial chemotherapy improved survival significantly at 2 years [difference, 22.8%; confidence interval (CI), 8.6–36.9%; P = 0.002] and 3 years (difference, 27.6%; CI, 8.2–47.1%; P = 0.005), and decreased the probability of no recurrence at 1 year (difference, 28.8%; CI, 16.7–40.8%; P