Source:http://linkedlifedata.com/resource/pubmed/id/20112254
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
4
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pubmed:dateCreated |
2010-4-7
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pubmed:abstractText |
Knowing the spontaneous outcome of hepatocellular carcinoma (HCC) is important for designing randomized controlled trials (RCTs) of new therapeutic approaches; however, survival of patients in the absence of treatment is highly variable, and prognostic factors influencing outcomes are incompletely defined. The aims of this meta-analysis were to estimate the 1-year and 2-year survival rates of untreated HCC patients enrolled in RCTs of palliative treatments, and to identify prognostic factors. RCTs evaluating therapies for HCC with placebo or no-treatment arms were identified on MEDLINE through April 2009. Data were combined in a random effect model. Primary outcomes were 1-year and 2-year survival. Thirty studies met the inclusion criteria. The pooled estimates of the survival rates were 17.5% at 1 year (95% confidence interval [95%CI], 11%-27%; range, 0%-75%) and 7.3% at 2 years (95%CI, 3.9%-13%; range, 0%-50%). Heterogeneity among studies was highly significant (P < 0.0001) both for 1-year and 2-year survival, and persisted when RCTs were stratified according to all patient and study features. Through meta-regression, impaired performance status, Child-Pugh B-C class, and presence of portal vein thrombosis were all independently associated with shorter survival. Ascites was strongly linked to a worse outcome in intermediate/advanced Barcelona Clinic Liver Cancer stages. Conclusion: This meta-analysis confirms the heterogeneity of behavior of untreated HCC and provides a sound basis for stratifying patients with HCC according to expected survival in future trials of new anti-cancer agents.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Apr
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pubmed:issn |
1527-3350
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pubmed:author | |
pubmed:issnType |
Electronic
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pubmed:volume |
51
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
1274-83
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pubmed:meshHeading |
pubmed-meshheading:20112254-Carcinoma, Hepatocellular,
pubmed-meshheading:20112254-Chemoembolization, Therapeutic,
pubmed-meshheading:20112254-Humans,
pubmed-meshheading:20112254-Liver Neoplasms,
pubmed-meshheading:20112254-Neoplasm Staging,
pubmed-meshheading:20112254-Publication Bias,
pubmed-meshheading:20112254-Randomized Controlled Trials as Topic,
pubmed-meshheading:20112254-Regression Analysis,
pubmed-meshheading:20112254-Survival Rate
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pubmed:year |
2010
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pubmed:articleTitle |
A meta-analysis of survival rates of untreated patients in randomized clinical trials of hepatocellular carcinoma.
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pubmed:affiliation |
Cattedra di Gastroenterologia, DIBIMIS, University of Palermo, Italy.
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pubmed:publicationType |
Journal Article,
Meta-Analysis
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