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Use of tamoxifen in advanced-stage hepatocellular carcinoma. A systematic review.

BACKGROUNDHepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide. Survival is poor for patients with advanced-stage HCC, and small trials of tamoxifen for patients with this disease have shown conflicting results. The authors conducted a systematic review of rand... Full description

Journal Title: Cancer Vol.103(7), pp.1408-1414
Main Author: Nowak, Anna K
Other Authors: Stockler, Martin R , Chow, Pierce K H , Findlay, Michael
Format: Electronic Article Electronic Article
Language: English
Subjects:
Created: April 1, 2005
ID: ISSN: 0008-543X
Link: http://search.proquest.com/docview/67549367/?pq-origsite=primo
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title: Use of tamoxifen in advanced-stage hepatocellular carcinoma. A systematic review.
format: Article
creator:
  • Nowak, Anna K
  • Stockler, Martin R
  • Chow, Pierce K H
  • Findlay, Michael
subjects:
  • Aged–Therapeutic Use
  • Antineoplastic Agents, Hormonal–Drug Therapy
  • Bias–Mortality
  • Carcinoma, Hepatocellular–Drug Therapy
  • Dose-Response Relationship, Drug–Mortality
  • Female–Adverse Effects
  • Humans–Therapeutic Use
  • Liver Neoplasms–Therapeutic Use
  • Male–Therapeutic Use
  • Middle Aged–Therapeutic Use
  • Quality of Life–Therapeutic Use
  • Randomized Controlled Trials As Topic–Therapeutic Use
  • Research Design–Therapeutic Use
  • Sex Factors–Therapeutic Use
  • Survival Rate–Therapeutic Use
  • Tamoxifen–Therapeutic Use
  • Abridged
  • Antineoplastic Agents, Hormonal
  • Tamoxifen
ispartof: Cancer, Vol.103(7), pp.1408-1414
description: BACKGROUNDHepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide. Survival is poor for patients with advanced-stage HCC, and small trials of tamoxifen for patients with this disease have shown conflicting results. The authors conducted a systematic review of randomized clinical trials to compare the effect of a tamoxifen-containing arm with a nontamoxifen-containing arm in advanced HCC. METHODSEligible trials were identified from the Cochrane Hepato-Biliary Group register and other databases. Studies were selected for inclusion and their methodologic quality assessed by three independent reviewers. Hazard ratios (HR) were derived for overall survival where possible. Metaanalysis was performed using a fixed-effect model. RESULTSThe authors identified 10 randomized trials with a total of 1709 patients. Use of tamoxifen had no effect on median survival (HR, 1.05; 95% confidence interval, 0.94-1.16; P = 0.4) or tumor response rate. The findings were stable in sensitivity analyses and were not affected by publication bias or inclusion of low-quality studies or studies reported in abstract form only. Few adverse events or withdrawals were noted. CONCLUSIONSThere was no support for the therapeutic use of tamoxifen in advanced HCC, nor for its use as a control arm in future clinical trials.
language: eng
source:
identifier: ISSN: 0008-543X
fulltext: fulltext
issn:
  • 0008543X
  • 0008-543X
url: Link


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titleUse of tamoxifen in advanced-stage hepatocellular carcinoma. A systematic review.
creatorNowak, Anna K ; Stockler, Martin R ; Chow, Pierce K H ; Findlay, Michael
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creationdateApril 1, 2005
ispartofCancer, Vol.103(7), pp.1408-1414
identifierISSN: 0008-543X
subjectAged–Therapeutic Use ; Antineoplastic Agents, Hormonal–Drug Therapy ; Bias–Mortality ; Carcinoma, Hepatocellular–Drug Therapy ; Dose-Response Relationship, Drug–Mortality ; Female–Adverse Effects ; Humans–Therapeutic Use ; Liver Neoplasms–Therapeutic Use ; Male–Therapeutic Use ; Middle Aged–Therapeutic Use ; Quality of Life–Therapeutic Use ; Randomized Controlled Trials As Topic–Therapeutic Use ; Research Design–Therapeutic Use ; Sex Factors–Therapeutic Use ; Survival Rate–Therapeutic Use ; Tamoxifen–Therapeutic Use ; Abridged ; Antineoplastic Agents, Hormonal ; Tamoxifen
descriptionBACKGROUNDHepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide. Survival is poor for patients with advanced-stage HCC, and small trials of tamoxifen for patients with this disease have shown conflicting results. The authors conducted a systematic review of randomized clinical trials to compare the effect of a tamoxifen-containing arm with a nontamoxifen-containing arm in advanced HCC. METHODSEligible trials were identified from the Cochrane Hepato-Biliary Group register and other databases. Studies were selected for inclusion and their methodologic quality assessed by three independent reviewers. Hazard ratios (HR) were derived for overall survival where possible. Metaanalysis was performed using a fixed-effect model. RESULTSThe authors identified 10 randomized trials with a total of 1709 patients. Use of tamoxifen had no effect on median survival (HR, 1.05; 95% confidence interval, 0.94-1.16; P = 0.4) or tumor response rate. The findings were stable in sensitivity analyses and were not affected by publication bias or inclusion of low-quality studies or studies reported in abstract form only. Few adverse events or withdrawals were noted. CONCLUSIONSThere was no support for the therapeutic use of tamoxifen in advanced HCC, nor for its use as a control arm in future clinical trials.
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titleUse of tamoxifen in advanced-stage hepatocellular carcinoma. A systematic review.
descriptionBACKGROUNDHepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide. Survival is poor for patients with advanced-stage HCC, and small trials of tamoxifen for patients with this disease have shown conflicting results. The authors conducted a systematic review of randomized clinical trials to compare the effect of a tamoxifen-containing arm with a nontamoxifen-containing arm in advanced HCC. METHODSEligible trials were identified from the Cochrane Hepato-Biliary Group register and other databases. Studies were selected for inclusion and their methodologic quality assessed by three independent reviewers. Hazard ratios (HR) were derived for overall survival where possible. Metaanalysis was performed using a fixed-effect model. RESULTSThe authors identified 10 randomized trials with a total of 1709 patients. Use of tamoxifen had no effect on median survival (HR, 1.05; 95% confidence interval, 0.94-1.16; P = 0.4) or tumor response rate. The findings were stable in sensitivity analyses and were not affected by publication bias or inclusion of low-quality studies or studies reported in abstract form only. Few adverse events or withdrawals were noted. CONCLUSIONSThere was no support for the therapeutic use of tamoxifen in advanced HCC, nor for its use as a control arm in future clinical trials.
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titleUse of tamoxifen in advanced-stage hepatocellular carcinoma. A systematic review.
authorNowak, Anna K ; Stockler, Martin R ; Chow, Pierce K H ; Findlay, Michael
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abstractBACKGROUNDHepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide. Survival is poor for patients with advanced-stage HCC, and small trials of tamoxifen for patients with this disease have shown conflicting results. The authors conducted a systematic review of randomized clinical trials to compare the effect of a tamoxifen-containing arm with a nontamoxifen-containing arm in advanced HCC. METHODSEligible trials were identified from the Cochrane Hepato-Biliary Group register and other databases. Studies were selected for inclusion and their methodologic quality assessed by three independent reviewers. Hazard ratios (HR) were derived for overall survival where possible. Metaanalysis was performed using a fixed-effect model. RESULTSThe authors identified 10 randomized trials with a total of 1709 patients. Use of tamoxifen had no effect on median survival (HR, 1.05; 95% confidence interval, 0.94-1.16; P = 0.4) or tumor response rate. The findings were stable in sensitivity analyses and were not affected by publication bias or inclusion of low-quality studies or studies reported in abstract form only. Few adverse events or withdrawals were noted. CONCLUSIONSThere was no support for the therapeutic use of tamoxifen in advanced HCC, nor for its use as a control arm in future clinical trials.
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