國家衛生研究院 NHRI:Item 3990099045/8581
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/8581


    Title: Association between ultrasonography screening and mortality in patients with hepatocellular carcinoma: A nationwide cohort study
    Authors: Wu, CY;Hsu, YC;Ho, HJ;Chen, YJ;Lee, TY;Lin, JT
    Contributors: National Institute of Cancer Research;Division of Health Services and Preventive Medicine
    Abstract: OBJECTIVE: Current guidelines recommend screening for hepatocellular carcinoma (HCC) in high-risk populations. However, the effectiveness of screening in reducing mortality has been challenged. In addition, it is unclear which subgroups benefit most from HCC screening. DESIGN: This nationwide cohort study identified a total of 52 823 newly diagnosed HCC patients between 1 January 2002 and 31 December 2007. These HCC patients were classified into the following cohorts according to the time intervals in which they received ultrasonography screening: 0-6 months (6M), 7-12 months (12M), 13-24 months (24M), 25-36 months (36M) and not screened within 3 years (never screened). The chance to receive curative therapy and 5-year cumulative mortalities were calculated after adjusting for lead-time bias. RESULTS: Chances to receive curative therapy among the 6M, 12M, 24M, 36M and never screened cohorts were 24.3% (95% CI 23.7% to -24.9%), 26.9% (95% CI 25.7% to 28.2%), 22.9% (95% CI 21.8% to 24.1%), 21.3% (95% CI 19.9% to 22.8%) and 18.3% (95% CI 17.8% to 18.8%), respectively. Compared with the 6M cohort, adjusted HRs of mortality for the 12M, 24M, 36M and never screened cohorts were 1.11 (95% CI 1.07 to 1.15), 1.23 (95% CI 1.19 to 1.28), 1.31 (95% CI 1.26 to 1.37) and 1.47 (95% CI 1.43 to 1.51) (all p<0.001), respectively. On multivariable subgroup analyses, the associations between shorter screening intervals and better survival were observed in nearly all subgroups, especially in younger patients, patients without diabetes and patients with hepatitis B infection. CONCLUSIONS: Shorter ultrasonography screening intervals are associated with reduced overall mortality in HCC patients in a dose-dependent manner.
    Date: 2016-04
    Relation: Gut. 2016 Apr;65(4):693-701.
    Link to: http://dx.doi.org/10.1136/gutjnl-2014-308786
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0017-5749&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000372171100019
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84930024541
    Appears in Collections:[Others] Periodical Articles
    [Jaw-Town Lin] Periodical Articles

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