Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma
Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma
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DOI：
10.1016/j.jhep.2014.03.037
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发表时间：
2014-08-01
影响因子：
25.7
通讯作者：
Pinna, Antonio D.
中科院分区：
文献类型：
--
作者：
Cucchetti, Alessandro;Trevisani, Franco;Pinna, Antonio D.
背景和目标：前置时间是指通过筛查/监测对疾病的症状检测预期诊断的时间。任何筛查项目，包括肝细胞癌（HCC）的监测，都存在提前期偏倚。缺乏关于合同委员会筹备时间的数据。本研究的目的是计算前置时间，并评估其对从监测腹泻患者中获得的益处的影响。来自ITA.LI.CA数据库的1380例Child-Pugh A/B级患者，在半年一次的监测中检测到HCC（n = 850），每年监测（n = 234）或当患者出现症状时（n = 296）。结果：HCC诊断后5年总生存率在半年监测组为32.7%，在每年监测组为25.2%，在有症状组为12.2%（P < 0.05），在有症状组为10.0%（P < 0.05）。
Background & Aims: Lead-time is the time by which diagnosis is anticipated by screening/surveillance with respect to the symptomatic detection of a disease. Any screening program, including surveillance for hepatocellular carcinoma (HCC), is subject to lead-time bias. Data regarding lead-time for HCC are lacking. Aims of the present study were to calculate lead-time and to assess its impact on the benefit obtainable from the surveillance of cirrhotic patients.Methods: One-thousand three-hundred and eighty Child-Pugh class A/B patients from the ITA.LI.CA database, in whom HCC was detected during semiannual surveillance (n = 850), annual surveillance (n = 234) or when patients came when symptomatic (n = 296), were selected. Lead-time was estimated by means of appropriate formulas and Monte Carlo simulation, including 1000 patients for each arm.Results: The 5-year overall survival after HCC diagnosis was 32.7% in semiannually surveilled patients, 25.2% in annually surveilled patients, and 12.2% in symptomatic patients (p