If a picture is worth a thousand words, take a good look at the picture: Survival after liver metastasectomy for colorectal cancer
If a picture is worth a thousand words, take a good look at the picture: Survival after liver metastasectomy for colorectal cancer
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DOI：
10.1016/j.canep.2017.06.009
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发表时间：
2017-08-01
影响因子：
2.6
通讯作者：
Treasure, Tom
中科院分区：
文献类型：
--
作者：
Morris, Eva;Treasure, Tom
引言：对莫里斯等人在《国民健康保险制度》中发表的数据的分析。2010年被广泛用作支持结直肠癌肝转移切除术及其更广泛应用的证据。最近关于转移性结直肠癌患者总体生存率较高的证据挑战了关于没有转移切除的生存率的概念性假设。早期发现局部治疗的转移并没有带来生存益处。材料和方法：对其中央图形显示的解释进行了批判性回顾，并探讨了注册数据分析的局限性和由此产生的不朽时间偏差。结果和讨论：最近的证据，包括2017年CLOCC试验报告，使最初的分析解释可疑。随机试验对于检测特定干预措施在各种疾病进展、选择偏向以及晚期癌症治疗中固有的多重和重复治疗之间的治疗效果至关重要。(C)2017爱思唯尔有限公司。保留所有权利。
Introduction: An analysis of NHS data published in by Morris et al. in 2010 is widely used as evidence in support of liver metastasectomy for colorectal cancer and its wider application. Recent evidence concerning better overall survival for patients with metastatic colorectal cancer challenges the notional assumptions about what survival would be without metastasectomy. Earlier detection of metastases for local treatments has not resulted in a survival benefit.Materials and methods: The interpretation of its central graphical display is critically reviewed and the common the limitations of the analysis of registry data and resulting immortal time bias are explored.Results and discussion: Recent evidence, including the 2017 CLOCC trial report make the original interpretation of the analysis suspect. Randomised trials are essential to detect a treatment effect of specific interventions among variable disease progression, selection bias, and multiple and repeated treatments that are inherent in the management of advanced cancer. (C) 2017 Elsevier Ltd. All rights reserved.