[Evidenced-based clinical practice of interventional therapy for advanced hepatocellular carcinoma:2-year follow-up results in 59 cases].
OBJECTIVE
To explore the methods of evidence-based medicine to determine objectives and evaluate the efficacy of interventional therapy for advanced hepatocellular carcinoma.


METHODS
Clinical questions were raised after a thorough evaluation of the status of interventional therapy. The term of evidence based medicine methods was searched in EBSCO, Cochrane library, Medline (January 1990-January 2007), ACP Journal Club (January 1991-January 2007) and Sumsearch. The searching subjects were hepatocellular carcinoma, interventional therapy, systematic review and meta-analysis etc. Based upon an analysis of the searching results, rational evidence based interventional therapy regimes were made. The survival benefit was studied by comparing with the empirical counterpart of the same period and with the same inclusion criteria. Data and Kaplan-Meier survival analyses were conducted by SPSS version 16.0 software.


RESULTS
Nine randomized controlled clinical trials related to clinical questions and three systematic reviews were retrieved. A total of 119 cases of hepatocellular carcinoma were included. The evidence-based interventional therapy was performed in 59 cases and empirical interventional therapy in other 60 cases. The 2-year follow-up results confirmed that the evidence-based regimes were more appropriate for advanced hepatocellular carcinoma. The 1 and 2-year overall survival rates in evidence-based interventional therapy group and empirical group were 79.7% vs 68.3% and 50.8% vs 31.7% respectively. And the difference was significant (P < 0.05).


CONCLUSIONS
Choosing the therapeutic regimes according to evidence-based medicine methods can increase the clinical efficacy of interventional therapy and achieve survival benefits.
Li
Bao-guo
BG
Department of Liver Transplantation and Laparoscopic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
Wen
Hao
H
Guo
Zhi
Z
Wang
Hai-tao
HT
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome