title: Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma patients after curative resection, a systematic review and meta-analysis.
abstract: BACKGROUND
  Cytokine-induced killer cells have been used as an adjuvant treatment for hepatocellular carcinoma with curative treatment. However, the outcomes remain controversial.
  
  
  OBJECTIVE
  We conducted this meta-analysis to assess the safety and efficacy of cytokine-induced killer cells.
  
  
  METHODS
  Randomized controlled trials on cytokine-induced killer cells for hepatocellular carcinoma after curative treatments were identified by electronic searches. A meta-analysis was carried out to examine disease-free survival, overall survival rate and adverse effect.
  
  
  RESULTS
  Six randomized controlled trials with 844 patients (85.9% with hepatitis B or C) were included. Our meta-analysis showed that cytokine-induced killer cells can not only improve the 1-year (RR=1.23, P<0.001), 2-year (RR=1.37, P<0.001) and 3-year (RR=1.35, P=0.004) disease-free survival, but also improve the 1-year (RR=1.08, P=0.001), 2-year (RR=1.14, P<0.001) and 3-year (RR=1.15, P=0.02) overall survival. However, it failed to affect the 4-year and 5-year disease-free survival and overall survival (P>0.05). At the same time, cytokine-induced killer cells treatment was proved to be a safe strategy with the comparable adverse events comparing to the control group (P=0.39).
  
  
  CONCLUSIONS
  This review provides the best available evidence that adjuvant cytokine-induced killer cells treatment can be safely used to improve the early disease-free survival and survival of hepatitis B or C related hepatocellular carcinoma.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Haiqing
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Aixiang
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Bo
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China. Electronic address: fengxielinszl@163.com.
authors.forename: Xielin
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Lang
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Tang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D055612:Cytokine-Induced Killer Cells / Q000276:immunology*; D018572:Disease-Free Survival; D006498:Hepatectomy; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
keywords: Cytokine-induced killer cells; Hepatectomy; Hepatocellular carcinoma; Immunotherapy