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New idea for treatment strategies for Barcelona Clinic Liver Cancer stages based on a network meta-analysis.

Abstract Currently, the Barcelona Clinic Liver Cancer staging (BCLC) system still remains controversies in the management of hepatocellular carcinoma. We are trying to determine the best therapeutic strategy for each BCLC stage through a network meta-analysis and provide a new treatment idea.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28514316
OWN - NLM
STAT- MEDLINE
DA  - 20170517
DCOM- 20170613
LR  - 20170613
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 20
DP  - 2017 May
TI  - New idea for treatment strategies for Barcelona Clinic Liver Cancer stages based 
      on a network meta-analysis.
PG  - e6950
LID - 10.1097/MD.0000000000006950 [doi]
AB  - BACKGROUND: Currently, the Barcelona Clinic Liver Cancer staging (BCLC) system
      still remains controversies in the management of hepatocellular carcinoma. We are
      trying to determine the best therapeutic strategy for each BCLC stage through a
      network meta-analysis and provide a new treatment idea. METHODS: We conducted a
      systematic literature search of the PubMed, EMBASE, and Cochrane Library
      databases and extracted data from randomized controlled trials (RCTs) that
      compared various strategies. Network meta-analyses were conducted in ADDIS by
      evaluating different overall survival of each stage. Cumulative probability was
      used to rank the included strategies. A node-splitting model assessed whether
      direct and indirect evidence on a specific node was in agreement. RESULTS: Of the
      24 included RCTs, 3667 patients were included. Based on the probability P values,
      the results showed that TACE plus surgical resection (SR) was the first choice
      for BCLC Stage A (P = .38 and P = .52 for 3- and 5-year OS, respectively). The
      application of SR was the best strategy for BCLC Stage B (P = .51 and P = .95 for
      1- and 3-year OS, respectively). For Stage C, whole net connections could not be 
      established in this research, but combined therapy seemed to produce better
      results based on 3 separated net connections (P = .92, P = .80, and P = .69 for
      1-year OS). CONCLUSIONS: The updated therapy strategies discussed in this study
      are recommended. More importantly, we deemed that the recommended strategy for
      each patient may be subject to adjustment due to individual clinical factors. The
      applicable scope of each strategy should also be evaluated before application.
FAU - Li, Kun
AU  - Li K
AD  - Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan, P.R.
      China.
FAU - Wang, Hai-Tao
AU  - Wang HT
FAU - He, Yu-Kun
AU  - He YK
FAU - Guo, Tao
AU  - Guo T
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Carcinoma, Hepatocellular/*pathology/*therapy
MH  - Humans
MH  - Liver Neoplasms/*pathology/*therapy
MH  - Neoplasm Staging
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
PMC - PMC5440153
EDAT- 2017/05/18 06:00
MHDA- 2017/06/14 06:00
CRDT- 2017/05/18 06:00
AID - 10.1097/MD.0000000000006950 [doi]
AID - 00005792-201705190-00033 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 May;96(20):e6950. doi: 10.1097/MD.0000000000006950.

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