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Survival after Locoregional Treatments for Hepatocellular Carcinoma: A Cohort Study in Real-World Patients

Authors :
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
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
Source :
The Scientific World Journal, The Scientific World Journal, Vol 2012 (2012)
Publication Year :
2012
Publisher :
The Scientific World Journal, 2012.

Abstract

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.

Details

Language :
English
ISSN :
1537744X and 23566140
Volume :
2012
Database :
OpenAIRE
Journal :
The Scientific World Journal
Accession number :
edsair.doi.dedup.....cc49f8005778db9251d35a85951e7819