Summary of findings 1. Chemotherapy versus no chemotherapy for intermediate‐stage hepatocellular carcinoma.
| Chemotherapy versus no chemotherapy for intermediate‐stage hepatocellular carcinoma | |||||
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Patient or population: people with intermediate‐stage hepatocellular carcinoma Settings: secondary or tertiary care Intervention: systemic chemotherapy Control: no systemic chemotherapy a Cointervention: transarterial chemoembolisation in both groups in 1 trial | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| No systemic chemotherapya | Systemic chemotherapya | ||||
| Mortality (at maximal follow‐up) ‐ chemotherapy versus no chemotherapy Median follow‐up in trials: 12 to 24 months | 500 per 1000 | 445 per 1000 (340 to 559) | HR 0.85 (0.60 to 1.18) | 412 (2 trials) | ⊕⊕⊝⊝ Very low1,2,3 |
| Short‐term and medium‐term mortality | None of the trials reported short‐term or medium‐term mortality. | ||||
| Adverse events | None of the trials reported adverse events. | ||||
| Quality of life | None of the trials reported quality of life at any time point. | ||||
| Disease recurrence | None of the trials reported disease recurrence. | ||||
| Length of hospital stay | None of the trials reported length of hospital stay. | ||||
| *The basis for the assumed risk was the control group proportion in the studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; HR: hazard ratio. | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Downgraded one level because of within‐study risk of bias: the trials were at high risk of bias.
2 Downgraded one level because of imprecision: the sample size was small.
3 Downgraded one level because of imprecision: the confidence intervals overlapped no effect and clinically significant effect.