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Survival after Locoregional Treatments for Hepatocellular Carcinoma: A Cohort Study in Real-World Patients
- 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.
- Subjects :
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1537744X and 23566140
- Volume :
- 2012
- Database :
- OpenAIRE
- Journal :
- The Scientific World Journal
- Accession number :
- edsair.doi.dedup.....cc49f8005778db9251d35a85951e7819