To evaluate the safety and feasibility of wait-and-see strategy for primary liver cancer (PLC) patients with complete response after sorafenib treatment.

1 case of PLC who achieved pathological complete response after interventional therapy combined with sorafenib therapy was reported. The informed consent of this patient was obtained and the local ethical committee approval was received. Relevant clinical studies were searched from PubMed, Embase, Ovid, Wanfang, CNKI and Chongqing VIP databases from January 2007 to April 2020 using the keywords hepatocellular carcinoma, sorafenib, complete response, complete pathological response in both Chinese and English. The 1-, 3- and 5-year overall survival and progression-free survival of PLC patients with complete response after sorafenib-based treatments were calculated. Survival analysis was conducted by Kaplan-Meier method and Log-rank test.

37 articles of 45 PLC patients, 39 male and 6 female, were included. The 1-, 3-, and 5-year overall survival rates were 100%, 94.3%, and 94.3%, and the progression-free survival rates were 100%, 89.3%, and 89.3%, respectively. Gender, age, AFP level, BCLC staging, portal vein tumor thrombus, extrahepatic metastasis, viral hepatitis, use of full-dose sorafenib, therapeutic regimen, resection of liver tumor and condition of remission were not significantly associated with the survival of patients (χ²=0.260, 1.411, 0.219, 0.852, 0.087, 1.838, 0.916, 1.065, 0.539, 0.027, 0.590; P>0.05) and disease recurrence (χ²=0.409, 1.899, 1.455, 3.300, 0.853, 0.557, 1.220, 0.006, 2.790, 0.894, 0.384; P>0.05).

PLC patients who achieve complete response after sorafenib-based treatments can obtain favorable clinical prognosis. Application of wait-and-see strategy is a safe option. Liver tumor resection or interventional therapy is not recommended.