# The role of vitamin K in the prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis

## TL;DR

This study finds that vitamin K, when used with standard treatment, may help improve outcomes for some patients with liver cancer, especially those who cannot have surgery.

## Contribution

The study provides new evidence on vitamin K's role in improving progression-free survival and reducing recurrence in hepatocellular carcinoma patients.

## Key findings

- Vitamin K combined with standard therapy prolonged progression-free survival in hepatocellular carcinoma patients.
- The combination of vitamin K and standard therapy significantly reduced recurrence risk in these patients.
- The benefits of vitamin K were more pronounced in patients treated with transarterial chemoembolization.

## Abstract

This meta-analysis aimed to evaluate the influence of vitamin K (VK) as an adjunctive therapy on the prognosis of patients with hepatocellular carcinoma (HCC), with a specific focus on its clinical value in non-resected individuals.

We systematically retrieved Chinese and English databases, including PubMed and Embase, to select randomized controlled trials (RCTs) and cohort studies comparing VK combined with standard therapy versus standard therapy alone. Methodological quality was evaluated via the Newcastle-Ottawa Scale for cohort studies and the Cochrane Risk of Bias tool (RoB-2) for RCTs. The primary endpoints were overall survival (OS) and progression-free survival (PFS). The secondary endpoint was recurrence risk. Pooled hazard ratios (HRs) and relative risks (RRs) were computed by fixed- or random-effects models. Subgroup analyses (surgery vs. transarterial chemoembolization [TACE]) and time stratification (12–48M) were conducted to explore heterogeneity sources.

Eleven studies involving 688 subjects were incorporated. The fixed-effects meta-analysis indicated that VK combined with standard therapy did not significantly improve OS (pooled HR = 0.77, 95% CI: 0.58–1.01). However, this combination prolonged PFS (pooled HR = 0.62, 95% CI: 0.47–0.82). Subgroup analysis based on PFS demonstrated more pronounced benefit in TACE-treated subjects (HR = 0.51, 95% CI: 0.34–0.77). Furthermore, VK combined with standard therapy reduced recurrence risk (pooled HR = 0.26, 95% CI: 0.15–0.46).

Adjunctive VK improves PFS and reduces recurrence risk in HCC subjects, demonstrating particular benefit for those with unresectable tumors receiving TACE. No significant OS advantage was observed. Future investigations should optimize VK dosing and administration strategies and explore its potential synergy with immunotherapy.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251106693, identifier CRD420251106693.