Effectiveness of sorafenib in combination with physical thermal ablation for hepatocellular carcinoma: A meta-analysis

Hepatocellular carcinoma (HCC) is the 6th most common cancer worldwide and claims roughly 700,000 lives each year; nearly 50% of global HCC fatalities occur in China. To conduct a comprehensive meta-analysis identifying predictors of sorafenib efficacy in combination with thermal ablation for HCC treatment. A comprehensive literature search was conducted up to October 2024, reviewing 720 identified studies. From these, 19 studies were selected that included a total of 3,341 participants with HCC at baseline. The meta-analysis examined the effects of sorafenib in combination with physical thermal ablation, using odds ratios (ORs) and 95% confidence intervals (95% CIs). Analyses were performed using two-sided methods and either fixed-effect or random-effects models, depending on the level of heterogeneity. The meta-analysis revealed that combining physical thermal ablation with sorafenib significantly improved outcomes in HCC patients: Overall survival (OS) was more than doubled (OR = 2.03; 95% CI: 1.55-2.67; p < 0.001), recurrence rates were significantly reduced (OR = 0.62; 95% CI: 0.39-0.98; p = 0.04), and overall treatment efficacy was markedly higher (OR = 2.53; 95% CI: 1.61-3.96; p < 0.001) compared with thermal ablation alone. In individuals with HCC, physical thermal ablation and sorafenib had significantly higher OS, lower recurrence rates, and high overall efficacy compared to physical thermal ablation. To validate this discovery, more research is needed, and caution must be implemented when interacting with its values.