title: Peri-operative use of sorafenib in liver transplantation: a time-to-event meta-analysis.
abstract: OBJECTIVE
  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 I(2) 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).
  
  
  CONCLUSIONS
  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.
authors: 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.
authors: Hao-Long
authors: HL
authors: Qi
authors: 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.
authors: Bing-Jie
authors: BJ
authors: Zhuang
authors: 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.
authors: Chang-Sheng
authors: CS
authors: Li
authors: 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.
authors: Quan-Yan
authors: QY
authors: Liu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D009536:Niacinamide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016017:Odds Ratio; D010671:Phenylurea Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D000077157:Sorafenib; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib
keywords: Hazard ratio; Kaplan-Meier curve; Liver transplantation; Peri-operative period; Sorafenib