{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:25:35Z","timestamp":1761560735064},"reference-count":70,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2001,12,25]],"date-time":"2001-12-25T00:00:00Z","timestamp":1009238400000},"content-version":"vor","delay-in-days":1423,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[1998,2]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>Controversies surrounding medical treatment in patients with unresectable hepatocellular carcinoma continue to persist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim:<\/jats:title><jats:p>To perform a meta\u2010analysis of therapeutic modalities which had been evaluated in two or more randomized trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Fifty\u2010two randomized trials were studied; only 30 were included. This overview identified seven therapeutic modalities which had been evaluated in two or more trials: adriamycin, 5\u2010fluorouracil, interferon, percutaneous ethanol injection, transarterial chemotherapy, the combination of lipiodol with transarterial chemotherapy, and tamoxifen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Comparisons of survival between control groups showed substantial heterogeneity. There was no survival benefit at 1\u2003year with adriamycin (mean difference 4%), 5\u2010fluorouracil (mean difference \u22123%), percutaneous ethanol injection (mean difference 6%) or transarterial chemotherapy (mean difference \u22122%). For interferon, the survival benefit was significant with the Der Simonian &amp; Laird method (mean difference 9%, 95% CI\u2003=\u20031\u201318%, <jats:italic>P<\/jats:italic>\u2003=\u20030.04) but not with the Peto <jats:italic>et al<\/jats:italic>. method (2.4 mean odds ratio, 95% CI\u2003=\u2003O.9\u20136.8). The meta\u2010analysis of tamoxifen showed a borderline survival benefit (mean difference 25%, 95% CI\u2003=\u20030\u201349%, <jats:italic>P<\/jats:italic>\u2003=\u20030.05). However, in sensitivity analyses, the survival benefit of tamoxifen was no longer significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>No treatment has clearly proven efficacy in survival. 5\u2010Fluorouracil, adriamycin and transarterial chemotherapy were not associated with survival benefit at 1\u2003year. The number of randomized controlled trials was insufficient to enable a conclusion to be reached for interferon and percutaneous ethanol injection. Controversy persists concerning tamoxifen efficacy. 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