ebm mia

3
APAKAH HASIL PENELITIAN TERSEBUT VALID? A. Petunjuk Primer 1. Apakah terdapat sampel yang representatif, terdefinisi jelas, dan berada pada kondisi yang sama dalam perjalanan penyakitnya? The criteria for surgical resection of HCC patients in this study were (1) patients with tumor invasion in single lobe or tumors in both lobes involving no more than 3 Healey’s segments, (2) Child-Turcotte-Pugh (CTP) class A or B with \25% retention of indocyanine green 15 min after injection, and (3) no main portal vein trunk involvement or distant metastasis. Variables associated with therapeutic strategy and longterm prognosis were comprehensively selected into the propensity score model involving 146 matched pairs of patients from each treatment arm (Table 3). There were no significant baseline differences in age, sex, etiology of liver disease, tumor-related parameters, severity of cirrhosis, performance status, vascular invasion, and cancer staging systems between the 2 patient groups. A matched study population was constructed to compare the long-term prognosis between these 2 groups. 2. Apakah follow-up cukup lama dan lengkap? Comparison of long-term survival between the 2 groups in the propensity model is shown in Fig. 3. Patients undergoing SR had significantly better long-term survival than patients receiving TACE (P\.001). During a mean follow-up period of 20 ± 17 months, 44 (30%) and 68 (47%) patients undergoing SR and TACE, respectively, died. The 1-, 3-, and 5-year survival rates of HCC patients receiving SR and TACE were 82% vs 65%, 68% vs 29%, and 46% vs 22%, respectively. In the univariate survival analysis, patients receiving TACE had significantly poorer

Upload: miamuhpian

Post on 28-May-2017

213 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: ebm mia

APAKAH HASIL PENELITIAN TERSEBUT VALID?

A. Petunjuk Primer

1. Apakah terdapat sampel yang representatif, terdefinisi jelas, dan berada pada kondisi yang

sama dalam perjalanan penyakitnya?

The criteria for surgical resection of HCC patients inthis study were (1) patients with tumor invasion in singlelobe or tumors in both lobes involving no more than 3Healey’s segments, (2) Child-Turcotte-Pugh (CTP) class Aor B with \25% retention of indocyanine green 15 minafter injection, and (3) no main portal vein trunk involvementor distant metastasis.

Variables associated with therapeutic strategy and longtermprognosis were comprehensively selected into thepropensity score model involving 146 matched pairs ofpatients from each treatment arm (Table 3). There were nosignificant baseline differences in age, sex, etiology of liverdisease, tumor-related parameters, severity of cirrhosis,performance status, vascular invasion, and cancer stagingsystems between the 2 patient groups. A matched studypopulation was constructed to compare the long-termprognosis between these 2 groups.

2. Apakah follow-up cukup lama dan lengkap?

Comparison of long-term survival between the 2 groups

in the propensity model is shown in Fig. 3. Patients

undergoing SR had significantly better long-term survival

than patients receiving TACE (P\.001). During a mean

follow-up period of 20 ± 17 months, 44 (30%) and 68

(47%) patients undergoing SR and TACE, respectively,

died. The 1-, 3-, and 5-year survival rates of HCC patients

receiving SR and TACE were 82% vs 65%, 68% vs 29%,

and 46% vs 22%, respectively. In the univariate survival

analysis, patients receiving TACE had significantly poorer

prognosis than patients receiving SR (HR: 2.44, 95% CI:

1.65–3.59; P\.001). In the multivariate Cox model, age

C65 years (HR: 2.13, 95% CI: 1.44–3.17; P\.001),

TACE (HR: 2.56, 95% CI: 1.73–3.78; P\.001), tumor

size C7 cm (HR: 1.62, 95% CI: 1.08–2.42; P = .019) and

vascular invasion (HR: 2.13, 95% CI: 1.44–3.17; P\.001)

were identified as independent predictors of poor prognosis

Page 2: ebm mia

APA HASILNYA?

1. Bagaimana gambaran outcome menurut waktu?

APAKAH HASIL PENELITIAN INI DAPAT DIAPLIKASIKAN?

1. Apakah pasien dalam penelitian tersebut serupa dengan pasien saya?

YA

2. Apakah hasil tersebut membantu memilih atau menghindari terapi tertentu?

YA

Dalam jurnal penelitian ini surgical resection merupakan terapi yang dipilih untuk pasien

karsinoma hepatoseluler stadium intermediate

3. Apakah hasilnya membantu dalam memberikan konseling kepada pasien saya?

YA

Dalam jurnal penelitian ini disebutkan bahwa hasil prognosis dilakukan surgical

resection bagi pasien karsinoma hepatoseluler stadium intermediate lebih baik dibanding

dengan TACE.