Evidence map›Paper›PMID 40703528›Full record

SynthesisFrontiers in immunology2025

Efficacy of therapies for intermediate-stage hepatocellular carcinoma: systematic review and network meta-analysis.

Shaoqi Zong, Yifan Yang, Zifei Yin, Lanyun Feng, Kun Wang, Hao Chen, Zhen Chen, Zhiqiang Meng, Yongqiang Hua

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Shaoqi Zong *Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Yifan Yang *Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Zifei Yin *School of Traditional Chinese Medicine, Naval Medical University, Shanghai, China.
Lanyun FengDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Kun WangDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Hao ChenDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Zhen ChenDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Zhiqiang MengDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Yongqiang HuaDepartment of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Transarterial chemoembolization (TACE) is recommended for intermediate-stage hepatocellular carcinoma (HCC). However, several therapies have shown better efficacy than TACE, meaning that the optimal therapy is unclear. We addressed this uncertainty using network meta-analysis (NMA). Methods: A literature review was performed up to March 15, 2024. Efficacy was evaluated using overall survival (OS) and progression-free survival (PFS). The hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted from the Kaplan-Meier curves. A random-effects NMA was conducted, and subgroup analysis was performed according to the tumor number, tumor size, viral etiology, and alpha fetoprotein (AFP) level. The efficacy of the different therapies was ranked based on the Results: A total of 38 studies, 10,972 patients, and 13 therapeutic regimens were eligible. Seven therapies showed OS benefit over TACE, including TACE plus microwave ablation (MWA) (HR = 0.24, 95%CI = 0.06-0.91), TACE plus liver resection (HR = 0.35, 95%CI = 0.22-0.57), liver resection plus RFA (HR =0.49,95%CI=0.35-0.70), TACE plus immune checkpoint inhibitors (ICIs) plus tyrosine kinase inhibitors (TKIs) (HR = 0.51, 95%CI = 0.27-0.95), liver resection (HR = 0.54, 95%CI = 0.45-0.65), and TACE plus radiofrequency ablation (RFA) (HR = 0.57, 95%CI = 0.36-0.93). However, no therapies improved the PFS better than TACE alone. Subgroup analysis indicated that liver resection plus TACE showed the best OS for patients with hepatitis B virus (HBV) infection. Conclusions: Seven therapies showed better efficacy than TACE alone for particular patients with intermediate-stage HCC. Systematic review registration: https://www.crd.york.ac.uk/, PROSPERO CRD42023459740.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsChemoembolization, TherapeuticCombined Modality TherapyHumansNeoplasm StagingTreatment Outcomeefficacyhepatocellular carcinomaintermediate stagenetwork meta-analysisTACE

Identifiers

PMID40703528
PMCPMC12283577

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.