Role of vitamin K2 in preventing the recurrence of hepatocellular carcinoma after curative treatment: A meta-analysis of randomized controlled trials
Affiliation
Department of Internal Medicine, University of Arizona, Tucson, AZ, USADow University of Health Sciences, Civil Hospital Karachi, Karachi, Pakistan
New York Methodist Hospital, New York, NY, USA
Albert Einstein College of Medicine, New York, NY, USA
James J. Peters VA Medical Center/Mount Sinai School of Medicine, New York, NY, USA
Issue Date
2012Metadata
Show full item recordPublisher
BioMed CentralCitation
Riaz et al. BMC Gastroenterology 2012, 12:170 http://www.biomedcentral.com/1471-230X/12/170Journal
BMC GastroenterologyRights
© 2012 Riaz et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)Collection Information
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.Abstract
BACKGROUND:Hepatocellular cancer is notorious for recurrence even after curative therapy. High recurrence determines the long term prognosis of the patients. Vitamin K2 has been tested in trials for its effect on prevention of recurrence and improving survival. The results are inconclusive from individual trials and in our knowledge no systematic review which entirely focuses on Vitamin K2 as a chemo preventive agent is available to date. This review is an attempt to pool all the existing trials together and update the existing knowledge on the topic.METHODS:Medline, Embase and Cochrane Register of Controlled trials were searched for randomized controlled trials where vitamin K2 or its analogues, in any dosage were compared to placebo or No vitamin K2, for participants of any age or sex. Reference lists and abstracts of conference proceedings were searched by hand. Additional papers were identified by a manual search of the references from the key articles. Attempt was made to contact the authors of primary studies for missing data and with the experts in the field.Trials were assessed for inclusion by two independent reviewers. Primary outcomes were recurrence rates and survival rates. There were no secondary outcomes. Data was synthesized using a random effects model and results presented as relative risk with 95% Confidence Intervals.RESULT:For recurrence of hepatocellular cancer after hepatic resection or local ablative therapy, compared with controls, participants receiving Vitamin K2, pooled relative risks for hepatocellular cancer were 0.6095% CI: 0.28-1.28, p=0.64) at 1 yr 0.66
95% CI: 0.47-0.91), p=0.01) at 2 yr
0.71
95% CI: 0.58-0.85, p=0.004) at 3 yr respectively. The results were combined using the random analysis model.CONCLUSION:Five RCTs evaluated the preventive efficacy of menatetrenone on HCC recurrence after hepatic resection or local ablative therapy. The meta-analysis of all five studies, failed to confirm significantly better tumor recurrence- free survival at 1 year. Improved tumor recurrence at 2nd and 3rd year may be just due to insufficient data. There was no beneficial effect on the overall survival. However, to confirm the beneficial effect or lack of it, large, higher quality randomized controlled trials are still required.