The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
A meta‐analysis of survival rates of untreated patients in randomized clinical trials of hepatocellular carcinoma†
Open accessAbstract
UNLABELLED: 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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Cites
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Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
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Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
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Sorafenib in advanced hepatocellular carcinoma
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EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
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“Intermediate HCC (BCLC stage B): Untreated patients at an intermediate stage – BCLC B class (multinodular asymptomatic tumors without an invasive pattern) present a median survival of 16 months [139,164], or 49% at 2 year [133].”
BackgroundInfluentialEASL Clinical Practice Guidelines on the management of hepatocellular carcinoma
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Wei, L., Lee, D., Law, C.-T., Zhang, M. S., Shen, J., Chin, D. W.-C., Zhang, A., Tsang, F. H.-C., Wong, C. L.-S., Ng, I. O.-L., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-12606-7 · Cited by 428
Colchicine-Binding Site Inhibitors from Chemistry to Clinic: A Review
McLoughlin, E. C., & O’Boyle, N. M. (2020) · Pharmaceuticals · doi:10.3390/ph13010008 · Cited by 316
Metadata
- Authors
- Cabibbo, G., Enea, M., Attanasio, M., Bruix, J., Craxì, A., & Cammà, C.
- Venue
- Hepatology
- Published
- 2010-04
- Volume
- 51
- Issue
- 4
- Pages
- 1274-1283
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2051193106
- Cited by
- 473
- References
- 35
- FWCI
- 9.60
- Type
- journal article
- Language
- en
- Open access
- bronze
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