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Long-term Outcomes of Ablation, Liver Resection, and Liver Transplant as First-line Treatment for Solitary HCC of 3 cm or Less

14. januar 2022 opdateret af: University Health Network, Toronto

Long-term Outcomes of Ablation, Liver Resection, and Liver Transplant as First-line Treatment for Solitary HCC of 3 cm or Less Using an Intention-to-treat Analysis: a Retrospective Cohort Study

Curative-intent therapies for hepatocellular carcinoma (HCC) include radiofrequency ablation (RFA), liver resection (LR), and liver transplantation (LT). Controversy exists in treatment selection for early-stage tumors. We sought to evaluate the oncologic outcomes of patients who received either RFA, LR, or LT as first-line treatment for solitary HCC ≤ 3cm in an intention-to-treat analysis.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

119

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult (≥18 years) patients with solitary HCC ≤ 3cm who underwent either RFA, LR, or were listed for an LT between Feb-2000, and Nov-2018.

Beskrivelse

Inclusion Criteria:

  • Adult (≥18 years) patients
  • Solitary HCC ≤ 3cm
  • Receipt of either radiofrequency ablation, liver resection, or listing for a liver transplant
  • Treatment received between Feb-2000 and Nov-2018

Exclusion Criteria:

  • Pathology other than hepatocellular carcinoma (HCC)
  • Receipt of prior treatment (i.e., not treatment naive)
  • Not eligible for all of the three treatments (ablation, liver resection, or liver transplant listing)
  • Platelet count <100,000 before treatment
  • Alpha-1 fetoprotein (AFP) level > 1000 before treatment
  • Age > 70 years
  • Child-Pugh score C
  • Esophageal varices grade greater than 2
  • Model for End-stage Liver Disease (MELD) score before treatment exceeding 15
  • Presence of ascites pretreatment
  • Presence of encephalopathy pretreatment
  • Spleen size greater than 12 cm

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Solitary HCC <= 3 cm
Treatment-naive patients with HCC <= 3 cm
Procedure: Radiofrequency ablation
Treatment-naive patients with solitary HCC <= 3 cm who received ablation as the first-line treatment
Procedure: Liver resection
Treatment-naive patients with solitary HCC <= 3 cm who underwent liver resection as the first-line treatment
Procedure: Liver transplantation
Treatment-naive patients with solitary HCC <= 3 cm who were listed for liver transplantation as the first-line treatment

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Intention-to-treat (ITT) overall survival
Tidsramme: Overall (median length of follow up of entire cohort 6.6 years)
ITT was evaluated from the first treatment modality that was selected for curative intent. In the case of RFA and LR this was recorded as the time of the treatment. In the case of LT, the intention-to-treat was recorded at the time of listing for transplantation. The ITT analysis thus accounted for patients who were placed on the waitlist but dropped out.
Overall (median length of follow up of entire cohort 6.6 years)
Disease-free survival (DFS).
Tidsramme: Overall (median length of follow up of entire cohort 6.6 years)
DFS was defined as the time after treatment during which the patient was alive and free of disease. For DFS, patients were censored at recurrence, death, or loss to follow up.
Overall (median length of follow up of entire cohort 6.6 years)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University Health Network, Toronto

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. februar 2000

Primær færdiggørelse (Faktiske)

30. november 2018

Studieafslutning (Faktiske)

21. december 2021

Datoer for studieregistrering

Først indsendt

31. december 2021

Først indsendt, der opfyldte QC-kriterier

31. december 2021

Først opslået (Faktiske)

14. januar 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

18. januar 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

14. januar 2022

Sidst verificeret

1. december 2021

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 16-5285.6

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

The data that support the findings of this study are unsuitable to post given that they contain potentially identifiable patient information. Moreover, the research ethics board at the University Health Network has only approved data to be stored and analyzed by the members of the institutional study team to minimize any breach of patient confidentiality.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Kliniske forsøg med Hepatocellulært karcinom

Kliniske forsøg med Radiofrequency ablation

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Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Bangladesh

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner