Survival after Locoregional Treatments for Hepatocellular Carcinoma: A Cohort Study in Real-World Patients
| Autor: | Paolo Chiodini, Francesco Perrone, Mario Fusco, Nicola Lama, Vincenzo Castaldo, F. Calise, Massimo Di Maio, Ilario de Sio, Graziano Olivieri, Ciro Gallo, Bruno Daniele, Giovanni Battista Gaeta, Giovanni G. Di Costanzo, Guido Piai, Giuseppe Signoriello, Simona Signoriello, Giampiero Marone, Mario Visconti, Rosario Lanzetta, Annalisa Annunziata |
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| Přispěvatelé: | Signoriello, Simona, Annunziata, A, Lama, N, Signoriello, Giuseppe, Chiodini, Paolo, De Sio, I, Daniele, B, Di Costanzo, Gg, Calise, F, Olivieri, G, Castaldo, V, Lanzetta, R, Piai, G, Marone, G, Visconti, M, Fusco, M, Di Maio, M, Perrone, F, Gallo, Ciro, Gaeta, Giovanni Battista |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Article Subject Radiofrequency ablation medicine.medical_treatment lcsh:Medicine Kaplan-Meier Estimate lcsh:Technology Gastroenterology General Biochemistry Genetics and Molecular Biology law.invention Randomized controlled trial law Internal medicine Medicine Humans lcsh:Science General Environmental Science Aged Proportional Hazards Models Retrospective Studies Chemotherapy lcsh:T business.industry Proportional hazards model lcsh:R Liver Neoplasms technology industry and agriculture Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery surgical procedures operative Treatment Outcome Hepatocellular carcinoma lcsh:Q Female Percutaneous ethanol injection business Cohort study Research Article |
| Zdroj: | The Scientific World Journal The Scientific World Journal, Vol 2012 (2012) |
| ISSN: | 1537-744X 2356-6140 |
| Popis: | Evidence of relative effectiveness of local treatments for hepatocellular carcinoma (HCC) is scanty. We investigated, in a retrospective cohort study, whether surgical resection, radiofrequency ablation (RFA), percutaneous ethanol injection (PEI), and transarterial embolization with (TACE) or without (TAE) chemotherapy resulted in different survival in clinical practice. All patients first diagnosed with HCC and treated with any locoregional therapy from 1998 to 2002 in twelve Italian hospitals were eligible. Overall survival (OS) was the unique endpoint. Three main comparisons were planned: RFA versus PEI, surgical resection versus RFA/PEI (combined), TACE/TAE versus RFA/PEI (combined). Propensity score method was used to minimize bias related to non random treatment assignment. Overall 425 subjects were analyzed, with 385 (91%) deaths after a median followup of 7.7 years. OS did not significantly differ between RFA and PEI (HR 1.11, 95% CI 0.79–1.57), between surgery and RFA/PEI (HR 0.95, 95% CI 0.64–1.41) and between TACE/TAE and RFA/PEI (HR 0.88, 95% CI 0.66–1.17). 5-year OS probabilities were 0.14 for RFA, 0.18 for PEI, 0.27 for surgery, and 0.15 for TACE/TAE. No locoregional treatment for HCC was found to be more effective than the comparator. Adequately powered randomized clinical trials are still needed to definitely assess relative effectiveness of locoregional HCC treatment. |
| Databáze: | OpenAIRE |
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