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1. Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Author

Maria Guarino, 1, Valentina Cossiga, 1, Mario Capasso, 1, Chiara Mazzarelli, 2, 3 4, Filippo Pelizzaro, Rodolfo Sacco, 5, Russo, FRANCESCO PAOLO, Vitale, Alessandro, 7 8, Franco Trevisani, Giuseppe Cabibbo, 9, Brancaccio, Giuseppina, The Associazione Italiana Per Lo Studio Del Fegato AISF HCC Special Interest Group, Maria Guarino, Valentina Cossiga, Mario Capasso, Chiara Mazzarelli, Filippo Pelizzaro, Rodolfo Sacco, Francesco Paolo Russo, Alessandro Vitale, Franco Trevisani, Giuseppe Cabibbo, Guarino, Maria, Cossiga, Valentina, Capasso, Mario, Mazzarelli, Chiara, Pelizzaro, Filippo, Sacco, Rodolfo, Russo, Francesco Paolo, Vitale, Alessandro, Trevisani, Franco, and Cabibbo, Giuseppe

Subjects
liver cancer, Settore MED/12 - Gastroenterologia, SARS-CoV-2, COVID-19, hepatocellular carcinoma, General Medicine
Abstract

Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.

Published
2022

3. Effect of direct-acting antivirals on future occurrence of hepatocellular carcinoma in compensated cirrhotic patients

Author

Cucchetti, Alessandro, D’Amico, Gennaro, Trevisani, Franco, Morelli, Maria Cristina, Vitale, Alessandro, Pinna, Antonio Daniele, Cescon, Matteo, Cillo, Umberto, Burra, Patrizia, Russo, Francesco P., Mescoli, Claudia, Rendina, Maria, Lupo, Luigi G., Losito, Francesco, Fucilli, Fabio, Brancaccio, Giusep-Pina, Persico, Marcello, Viganò, Luca, Iavarone, Massimo, D’Ambrosio, Roberta, Sangiovanni, Angelo, Renzulli, Matteo, Galati, Giovanni, Ponziani, Francesca Romana, Pompili, Maurizio, Miele, Luca, Grieco, Antonio, Rapaccini, Gianlodovico, Gasbarrini, Antonio, Sandri, Giovanni Battisa Levi, Lai, Quirino, Melandro, Fabio, Rossi, Massimo, Lenci, Ilaria, Manzia, Tommaso Maria, Tortora, Raffaella, Di Costanzo, Giovan Giuseppe, Sacco, Rodolfo, Simonetti, Natalia, Morisco, Filomena, Guarino, Maria, Cabibbo, Giuseppe, Bhoori, Carlo Sposito Sherrie, Di Sandro, Stefano, Foschi, Francesco Giuseppe, Gardini, Andrea Casadei, Nicolini, Daniele, Mazzocato, Susanna, Alba, Kostandini, Violi, Paola, Baccarani, Umberto, Pravisani, Riccardo, A. Cucchetti, G. D'Amico, F. Trevisani, M.C. Morelli, A. Vitale, A.D.Pinna, M. Cescon, Cucchetti, Alessandro, D’Amico, Gennaro, Trevisani, Franco, Morelli, Maria Cristina, Vitale, Alessandro, Pinna, Antonio Daniele, Cescon, Matteo, Cillo, Umberto, Burra, Patrizia, Russo, Francesco P., Mescoli, Claudia, Rendina, Maria, Lupo, Luigi G., Losito, Francesco, Fucilli, Fabio, Brancaccio, Giusep-Pina, Persico, Marcello, Viganò, Luca, Iavarone, Massimo, D’Ambrosio, Roberta, Sangiovanni, Angelo, Renzulli, Matteo, Galati, Giovanni, Ponziani, Francesca Romana, Pompili, Maurizio, Miele, Luca, Grieco, Antonio, Rapaccini, Gianlodovico, Gasbarrini, Antonio, Sandri, Giovanni Battisa Levi, Lai, Quirino, Melandro, Fabio, Rossi, Massimo, Lenci, Ilaria, Manzia, Tommaso Maria, Tortora, Raffaella, Di Costanzo, Giovan Giuseppe, Sacco, Rodolfo, Simonetti, Natalia, Morisco, Filomena, Guarino, Maria, Cabibbo, Giuseppe, Bhoori, Carlo Sposito Sherrie, Di Sandro, Stefano, Foschi, Francesco Giuseppe, Gardini, Andrea Casadei, Nicolini, Daniele, Mazzocato, Susanna, Alba, Kostandini, Violi, Paola, Baccarani, Umberto, and Pravisani, Riccardo

Subjects
Male, Time Factors, Sustained Virologic Response, Hepatocellular carcinoma, Hepacivirus, Direct-acting antiviral, Direct-acting antivirals, medicine.disease_cause, Gastroenterology, Competing risk, Hepatitis C, Markov model, Survival benefit, Sustained virological response, Hepatology, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, biology, Incidence, Incidence (epidemiology), Liver Neoplasms, Middle Aged, Markov Chains, Competing risk Direct-acting antivirals Hepatitis C Hepatocellular carcinoma Markov model Survival benefit Sustained virological response, Italy, Liver Neoplasm, Female, 030211 gastroenterology & hepatology, Human, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factor, Hepatitis C virus, Antiviral Agents, 03 medical and health sciences, Internal medicine, medicine, Humans, Antiviral Agent, Hepaciviru, business.industry, Risk Factor, Carcinoma, Hepatocellular, Markov Chain, medicine.disease, biology.organism_classification, digestive system diseases, Settore MED/18 - Chirurgia Generale, Liver function, Varices, business
Abstract

Background: The achievement of high rates of sustained virological response (SVR) with direct-acting antivirals (DAAs) in hepatitis C virus (HCV) infected patients will reduce decompensating terminal events. Aims: To investigate whether hepatocellular carcinoma (HCC) occurrence could change due to the DAA-induced increase in life-expectancy. Methods: A Markov model was built on clinical data of 494 cirrhotic patients and available literature to estimate probabilities of “death before HCC” and of “HCC occurrence” without and with DAA. Results: In comparison to untreated patients, DAA therapy reduced the 20-year mortality before HCC by 21.9% in patients without varices and by 21.5% in those with varices, considering an SVR of 95% and no direct effect on hepatocarcinogenesis. Tumour occurrence increased by 5%–8.2% and the proportion of HCCs diagnosed in compensated stages increased to >98%. If we consider DAA as having “anti-tumoral” effects, the benefit becomes greater, achieving a 20-year survival of 81.5% in patients without varices, and 52.2% in patients with varices. Instead, if we consider DAA as having a “pro-tumoral” effect, then, the increased incidence of HCC nullifies the survival benefits. Conclusion: DAAs drastically reduce the mortality caused by the liver function worsening, increasing the proportion of HCCs diagnosed in compensated stages. Knowledge of the DAA effect on hepatocarcinogenesis remains pivotal. © 2017 Editrice Gastroenterologica Italiana S.r.l.

Published
2018
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4. Defining the possible therapeutic benefit of lymphadenectomy among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Author

Vitale, Alessandro, Moustafa, MOHAMED EZELDIN MOUSTAFA FARRAG, Spolverato, Gaya, Gani, Faiz, Cillo, Umberto, and Pawlik, Timothy M.

Subjects
intrahepatic cholangiocarcinoma, liver surgery, lymphadenectomy, survival, Surgery, Oncology, Adult, Aged, 80 and over, Male, Middle Aged, Survival Analysis, Cholangiocarcinoma, Bile Ducts, Intrahepatic, Treatment Outcome, Bile Duct Neoplasms, Hepatectomy, Humans, Lymph Node Excision, Female, Propensity Score, Aged, Follow-Up Studies, Retrospective Studies, SEER Program
Abstract

The aim of the study was to investigate the therapeutic role of lymphadenectomy (LND) in patients with intrahepatic cholangiocarcinoma.826 patients who underwent liver resection were identified using the SEER database from 1988 to 2011. Two groups of patients were defined: 201 (24%) undergoing potentially therapeutic LND (group A,3 lymph nodes (LN) removed), and 625 (76%) not receiving therapeutic LND (group B, ≤3 LNs removed). A propensity score analysis was performed to create a matched cohort of 402 patients (201 in either group). The survival benefit of therapeutic LND was also estimated using multivariate parametric analysis comparing two simulated cohorts of 826 patients.1-, 3-, and 5-year survival rates were 71%, 37%, and 27% for group A patients, and 73%, 37%, and 27% for matched group B patients (P = 0.656). When simulation analysis was performed, a moderate survival benefit of LND of 5.46 months was calculated (95%CI, 4.64-6.29). Considerable differences in LND survival benefit predictions were found according to patient's sex (males, 9.90 vs. females 1.16 months), age (≤60 years, 15 vs.60 years, -1.34 months), and tumor size (50 mm, 9.20 vs. ≤50 mm, -0.28).LND therapeutic benefit among a subset of patients. Future work is required to investigate the role of routine LND among these patients. J. Surg. Oncol. 2016;113:685-691. © 2016 Wiley Periodicals, Inc.

Published
2016

5. Protein body formation in the endoplasmic reticulum as an evolution of storage protein sorting to vacuoles: insights from maize γ-zein

Author

Vitale Alessandro, Emanuela Pedrazzini, Francesca Morandini, Davide Mainieri, Andrea Saccani, and Marie Maîtrejean

Subjects
chemistry.chemical_classification, biology, Endoplasmic reticulum, seed storage proteins, disulfide bonds, Vacuole, Plant Science, lcsh:Plant culture, Zea mays, Amino acid, endoplasmic reticulum, Biochemistry, chemistry, Protein body, biology.protein, Storage protein, lcsh:SB1-1110, Original Research Article, Prolamin, evolution of the secretory pathway, Secretory pathway, Cysteine
Abstract

The albumin and globulin seed storage proteins present in all plants accumulate in storage vacuoles. Prolamins, which are the major proteins in cereals seeds and are present only there, instead accumulate within the endoplasmic reticulum (ER) lumen as very large insoluble polymers termed protein bodies. Inter-chain disulfide bonds play a major role in polymerization and insolubility of many prolamins. The N-terminal domain of the maize prolamin 27 kD gamma-zein is able to promote protein body formation when fused to other proteins and contains seven cysteine residues involved in interchain bonds. We show that progressive substitution of these amino acids with serine residues in full length gamma-zein leads to similarly progressive increase in solubility and availability to traffic from the ER along the secretory pathway. Total substitution results in very efficient secretion, whereas the presence of a single cysteine is sufficient to promote partial sorting to the vacuole via a wortmannin-sensitive pathway, similar to the traffic pathway of vacuolar storage proteins. We propose that the mechanism leading to accumulation of prolamins in the ER is a further evolutionary step of the one responsible for accumulation in storage vacuoles.

Published
2014
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8. SUPPORTO NUTRIZIONALE CON LA PEG NEI TRAPIANTI DI FEGATO CUORE E POLMONE D. Neri, A. Da Riva*, P. Boccagni , M. Loy, P. Feltracco, F. D’Amico, F. D’Amico, E. Gringeri, F. D’Amico, A. Vitale, F.E. D’Amico, M. Polacco, A. Bertacco, G. Noaro, U. Cillo, Padova – XXXVI Congresso Nazionale SITO (Società Italiana Trapianti d’Organo), Torino 18-20 Ottobre 2012

Author

Neri, Daniele, Da Riva*, A., Boccagni, Patrizia, Loy, M., Feltracco, Paolo, D’Amico, F., Gringeri, Enrico, Vitale, Alessandro, D’Amico, F. E., Polacco, M., Bertacco, A., Noaro, G., and Cillo, Umberto

Published
2012

24. PROSPECTIVE RANDOMIZED MULTICENTRE PHASE III STUDY OF LIVER PERFUSION WITH HTK SOLUTION COMPARED WITH UW OR CELSIOR SOLUTIONS IN THE SETTING OF LIVER TRANSPLANTATION

Author

Brolese, Alberto, Avolio, Alfonso, Mirabella, Stefano, Rossi, Giorgio, Baccarani, Umberto, Nardo, Bruno, Rondinara, Gianfranco, Montalti, Roberto, Ciarleglio Francesco, A., Vitale, Alessandro, Melada, Ernesto, Bertelli, Riccardo, De Carlis Luciano, Agnes, Salvatore, Gerunda Giorgio, E., Bresadola, Fabrizio, Salizzoni, Mauro, D'Amico Davide, F., and Cillo, Umberto

Published
2008

25. Hepatocellular carcinoma in elderly patients: a concise review on systemic therapy with sorafenib

Author

Sara Lonardi, Cillo Umberto, Pambuku Ardi, Bellu Luisa, Zagonel Vittorina, Aliberti Camillo, Vitale Alessandro, Marsico Valentina, Crivellari Gino, and Lombardi Giuseppe

Subjects
Oncology, Sorafenib, medicine.medical_specialty, Chemotherapy, Hepatology, business.industry, medicine.medical_treatment, medicine.disease, Systemic therapy, Hepatocellular carcinoma, Internal medicine, medicine, business, medicine.drug
Published
2015
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27. EASE SCORE, NOVEL ALGORITHM BASED ON KINETICS OF AST, BILIRUBIN, PLATELETS AND RECIPIENT DATA TO PREDICT EARLY ALLOGRAFT FAILURE. AN ITALIAN MULTICENTER STUDY DESIGNED IN THE PERSPECTIVE OF LIVER RE-TRANSPLANTATION WITH UK VALIDATION

Author

Franco, Antonio, Simone, Paolo, Schlegel, Andrea, Lai, Quirino, Burra, Patrizia, Patrono, Damiano, Meli, Sonia, Ravaioli, Matteo, Bassi, Domenico, Ferla, Fabio, DUILIO PAGANO, Violi, Paola, Camagni, Stefania, Dondossola, Daniele, Montalti, Roberto, Alrawashdeh, Wasfi, Vitale, Alessandro, Teofili, Luciana, Ghinolfi, Davide, Spoletini, Gabriele, Maroni, Lorenzo, Nicolotti, Nicola, Magistri, Paolo, Pastena, Dario, Bongini, Marco, Rossi, Massimo, Mazzaferro, Vincenzo, Di Benedetto, Fabrizio, Hammond, John, Vivarelli, Marco, Agnes, Salvatore, Colledan, Michele, Carraro, Amedeo, Carlis, Luciano, Cescon, Matteo, Caccamo, Lucio, Gruttadauria, Salvatore, Muiesan, Paolo, Cillo, Umberto, Romagnoli, Renato, Avolio, Alfonso, Franco, A, De Simone, P, Schlegel, A, Lai, Q, Burra, P, Patrono, D, Meli, S, Ravaioli, M, Bassi, D, Ferla, F, Pagano, D, Violi, P, Camagni, S, Dondossola, D, Montalti, R, Alrawashdeh, W, Vitale, A, Teofili, L, Ghinolfi, D, Spoletini, G, Maroni, L, Nicolotti, N, Magistri, P, Pastena, D, Bongini, M, Rossi, M, Mazzaferro, V, Di Benedetto, F, Hammond, J, Vivarelli, M, Agnes, S, Colledan, M, Carraro, A, De Carlis, L, Cescon, M, Caccamo, L, Gruttadauria, S, Muiesan, P, Cillo, U, Romagnoli, R, and Avolio, A

Subjects
LIVER RE-TRANSPLANTATION

28. Traffic data acquirement by unmanned aerial vehicle

Author

Giuseppe Salvo, Alessandro Vitale, Luigi Caruso, Giuseppe Guido, Alessandro Scordo, Salvo, Giuseppe, Caruso, Luigi, Scordo, Alessandro, Guido, Giuseppe, and Vitale, Alessandro

Subjects
0209 industrial biotechnology, Atmospheric Science, Traffic data, Geographic information system, Relation (database), UAV, GPS, 02 engineering and technology, vehicle trajectorie, Vehicle Information and Communication System, Transport engineering, lcsh:Oceanography, 020901 industrial engineering & automation, Computers in Earth Science, 0502 economics and business, lcsh:GC1-1581, Computers in Earth Sciences, Simulation, General Environmental Science, Road user, 050210 logistics & transportation, business.industry, Applied Mathematics, lcsh:QE1-996.5, 05 social sciences, Traffic flow, Video image, lcsh:Geology, Geography, Settore ICAR/05 - Trasporti, Global Positioning System, business, vehicle trajectories
Abstract

This paper presents a methodology aimed to acquire traffic flow data through the employment of unmanned aerial vehicles (UAVs). The study is focused on the determination of driving behavior parameters of road users and on the reconstruction of traffic flow Origin/Destination matrix. The methodology integrates UAV flights with video image processing technique, and the capability of geographic information systems, to represent spatiotemporal phenomena. In particular, analyzing different intersections, the attention of the authors is focused on users’ gap acceptance in a naturalistic drivers’ behavior condition (drivers are not influenced by the presence of instruments and operators on the roadway) and on the reconstruction of vehicle paths. Drivers’ level of aggressiveness is determined by understanding how drivers decide that a gap is crossable and, consequently, how their behavior is critical in relation to a moving stream of traffic with serious road safety implications. The results of these experiments highlight the usefulness of the UAVs technology, that combined with video processing technique allows the capture of real traffic conditions with a good level of accuracy.

Published
2017
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29. Overview of Immune Checkpoint Inhibitors Therapy for Hepatocellular Carcinoma, and The ITA.LI.CA Cohort Derived Estimate of Amenability Rate to Immune Checkpoint Inhibitors in Clinical Practice

Author

Edoardo G. Giannini, Andrea Aglitti, Mauro Borzio, Martina Gambato, Maria Guarino, Massimo Iavarone, Quirino Lai, Giovanni Battista Levi Sandri, Fabio Melandro, Filomena Morisco, Francesca Romana Ponziani, Maria Rendina, Francesco Paolo Russo, Rodolfo Sacco, Mauro Viganò, Alessandro Vitale, Franco Trevisani, on behalf of the Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group, Giannini, Edoardo, Aglitti, Andrea, Borzio, Mauro, Gambato, Martina, Guarino, Maria, Iavarone, Massimo, Lai, Quirino, Levi Sandri, Giovanni, Melandro, Fabio, Morisco, Filomena, Ponziani, Francesca, Rendina, Maria, Russo, Francesco, Sacco, Rodolfo, Viganò, Mauro, Vitale, Alessandro, Trevisani, Franco, and Edoardo G. Giannini, Andrea Aglitti, Mauro Borzio, Martina Gambato, Maria Guarino, Massimo Iavarone, Quirino Lai, Giovanni Battista Levi Sandri, Fabio Melandro, Filomena Morisco, Francesca Romana Ponziani, Maria Rendina, Francesco Paolo Russo, Rodolfo Sacco, Mauro Viganò, Alessandro Vitale, Franco Trevisani, Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group

Subjects
0301 basic medicine, Cancer Research, medicine.medical_treatment, check-point inhibitors, immunotherapy, liver disease, outcome, Ipilimumab, Review, lcsh:RC254-282, 03 medical and health sciences, 0302 clinical medicine, Cancer immunotherapy, Atezolizumab, medicine, Ticilimumab, business.industry, Immunotherapy, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Immune checkpoint, Check-point inhibitor, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Cancer research, Nivolumab, business, Tremelimumab, medicine.drug
Abstract

Despite progress in our understanding of the biology of hepatocellular carcinoma (HCC), this tumour remains difficult-to-cure for several reasons, starting from the particular disease environment where it arises—advanced chronic liver disease—to its heterogeneous clinical and biological behaviour. The advent, and good results, of immunotherapy for cancer called for the evaluation of its potential application also in HCC, where there is evidence of intra-hepatic immune response activation. Several studies advanced our knowledge of immune checkpoints expression in HCC, thus suggesting that immune checkpoint blockade may have a strong rationale even in the treatment of HCC. According to this background, initial studies with tremelimumab, a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor, and nivolumab, a programmed cell death protein 1 (PD-1) antibody, showed promising results, and further studies exploring the effects of other immune checkpoint inhibitors, alone or with other drugs, are currently underway. However, we are still far from the identification of the correct setting, and sequence, where these drugs might be used in clinical practice, and their actual applicability in real-life is unknown. This review focuses on HCC immunobiology and on the potential of immune checkpoint blockade therapy for this tumour, with a critical evaluation of the available trials on immune checkpoint blocking antibodies treatment for HCC. Moreover, it assesses the potential applicability of immune checkpoint inhibitors in the real-life setting, by analysing a large, multicentre cohort of Italian patients with HCC.

Published
2019

30. Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Author

Maria Teresa Sartori, Agostino Colli, Francesco Violi, Armando Tripodi, Alessandro Vitale, Pier Mannuccio Mannucci, Paolo Caraceni, Paolo Angeli, Vincenzo La Mura, Cristina Lucidi, Laura Napoleone, Paolo Feltracco, Elvira Grandone, Fabio Piscaglia, Daniele Prati, Marco Marzioni, Massimo Zuin, Angelo Andriulli, Paolo Rebulla, Dario Ribero, Gianluca Svegliati Baroni, Anna Licata, Marco Marietta, Oliviero Riggio, Antonella Tufano, Erica Villa, Marco Senzolo, Filippo Schepis, Antonella Scalera, Sergio Maimone, Massimo Siciliano, Lesley De Pietri, Domenico Ferro, Giovanni Di Minno, Vincenza Calvaruso, Marco Falcone, Edoardo G. Giannini, David Sacerdoti, Valeria Raparelli, Stefania Basili, Filomena Morisco, Salvatore Piano, Carlo Merkel, Massimo Primignani, Andriulli, Angelo, Tripodi, Armando, Angeli, Paolo, Senzolo, Marco, Primignani, Massimo, Giannini, Edoardo G., Riggio, Oliviero, Colli, Agostino, Prati, Daniele, Sacerdoti, David, Merkel, Carlo, Basili, Stefania, Ferro, Domenico, Villa, Erica, Di Minno, Giovanni, Caraceni, Paolo, Marzioni, Marco, Mannucci, Pier Mannuccio, Violi, Francesco, Piscaglia, Fabio, Calvaruso, Vincenza, De Pietri, Lesley, Falcone, Marco, Feltracco, Paolo, Grandone, Elvira, La Mura, Vincenzo, Licata, Anna, Lucidi, Cristina, Maimone, Sergio, Marietta, Marco, Morisco, Filomena, Napoleone, Laura, Piano, Salvatore, Raparelli, Valeria, Rebulla, Paolo, Ribero, Dario, Sartori, Maria Teresa, Scalera, Antonella, Schepis, Filippo, Sicilianom, Massimo, Baroni, Gianluca Svegliati, Tufano, Antonella, Vitale, Alessandro, Zuin, Massimo, DI MINNO, Giovanni, Angelo, A, Armando, T, Paolo, A, Marco, S, Massimo, P, Edoardo G., G, Oliviero, R, Agostino, C, Daniele, P, David, S, Carlo, M, Stefania, B, Domenico, F, Erica, V, Giovanni Di, M, Paolo, C, Marco, M, Pier Mannuccio, M, Francesco, V, Fagiuoli, S, Andriulli, A, Tripodi, A, Angeli, P, Senzolo, M, Primignani, M, Giannini, EG, Riggio, O, Colli, A, Prati, D, Sacerdoti, D, Merkel, C, Basili, S, Ferro, D, Villa, E, Di Minno, G, Caraceni, P, Marzioni, M, Mannucci, PM, Violi, F, Piscaglia, F, Calvaruso, V, De Pietri, L, Falcone, M, Feltracco, P, Grandone, E, La Mura, V, Licata, A, Lucidi, C, Maimone, S, Marietta, M, Morisco, F, Napoleone, L, Piano, S, Raparelli, V, Rebulla, P, Ribero, D, Sartori, M, Scalera, A, Schepis, F, Siciliano, M, Baroni, G.S, Tufano, A, Vitale, A, and Zuin, M

Subjects
Liver Cirrhosis, Cirrhosis, Bleeding, Hemostasis, Thrombosis, Hepatology, Gastroenterology, Settore MED/09 - Medicina Interna, Anticoagulants, Coagulants, Drug Monitoring, Esophageal and Gastric Varices, Gastrointestinal Hemorrhage, Humans, Postoperative Hemorrhage, Blood Coagulation Tests, 0302 clinical medicine, Esophageal and Gastric Varice, Blood coagulation test, Consensus conference, Optimal management, Coagulant, 030220 oncology & carcinogenesis, Thrombosi, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, Liver Cirrhosi, NO, 03 medical and health sciences, Internal medicine, medicine, In patient, Intensive care medicine, Cirrhosi, business.industry, Anticoagulant, Hemostasi, Blood Coagulation Test, medicine.disease, Surgery, business
Abstract

Patients with cirrhosis present with hemostatic alterations secondary to reduced availability of pro-coagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

Published
2016

31. Survival benefit of liver resection for patients with hepatocellular carcinoma across different Barcelona Clinic Liver Cancer stages: a multicentre study

Author

Vitale A, Burra P, Frigo AC, Farinati F, Spolverato G, Volk M, Giannini EG, Ciccarese F, Rapaccini GL, Di Marco M, Caturelli E, Borzio F, Cabibbo G, Felder M, Gasbarrini A, Sacco R, Foschi FG, Missale G, Morisco F, Svegliati Baroni G, Virdone R, Cillo U, Italian Liver Cancer group, TREVISANI, FRANCO, PISCAGLIA, FABIO, ZOLI, MARCO, BERNARDI, MAURO, BOLONDI, LUIGI, BISELLI, MAURIZIO, CARACENI, PAOLO, CUCCHETTI, ALESSANDRO, DOMENICALI, MARCO, GRAMENZI, ANNAGIULIA, Vitale, A., Burra, P., Frigo, A. C., Trevisani, F., Farinati, F., Spolverato, G., Volk, M., Giannini, E. G., Ciccarese, F., Piscaglia, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Cabibbo, G., Felder, M., Gasbarrini, A., Sacco, R., Foschi, F. G., Missale, G., Morisco, F., Svegliati Baroni, G., Virdone, R., Cillo, U, Olmi, S, on behalf of Italian Liver Cancer, (ITA. LI. CA) group., Vitale, Alessandro, Burra, Patrizia, Frigo, Anna Chiara, Trevisani, Franco, Farinati, Fabio, Spolverato, Gaya, Volk, Michael, Giannini, Edoardo G, Ciccarese, Francesca, Piscaglia, Fabio, Rapaccini, Gian Lodovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Cabibbo, Giuseppe, Felder, Martina, Gasbarrini, Antonio, Sacco, Rodolfo, Foschi, Francesco Giuseppe, Missale, Gabriele, Morisco, Filomena, Svegliati Baroni, Gianluca, Virdone, Roberto, Cillo, Umberto, Guarino, Maria, Vitale A, Burra P, Frigo AC, Trevisani F, Farinati F, Spolverato G, Volk M, Giannini EG, Ciccarese F, Piscaglia F, Rapaccini GL, Di Marco M, Caturelli E, Zoli M, Borzio F, Cabibbo G, Felder M, Gasbarrini A, Sacco R, Foschi FG, Missale G, Morisco F, Svegliati Baroni G, Virdone R, Cillo U, Italian Liver Cancer (ITA.LI.CA) group, Bernardi M, Bolondi L, Biselli M, Caraceni P, Cucchetti A, Domenicali M, and Gramenzi A

Subjects
Male, medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, Loco-regional therapie, Hepatocellular carcinoma, Settore MED/12 - GASTROENTEROLOGIA, Hepatitis C virus, Kaplan-Meier Estimate, medicine.disease_cause, Gastroenterology, Cohort Studies, Liver disease, Interquartile range, Internal medicine, medicine, Humans, Best supportive care, Liver resection, Loco-regional therapies, Survival benefit, Aged, Female, Italy, Liver Neoplasms, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prognosis, Treatment Outcome, Medicine (all), Hepatology, BEST SUPPORTING CARE, Cirrhosi, Performance status, business.industry, CIRRHOISIS, Carcinoma, Hepatocellular, medicine.disease, BCLC Stage, Liver cancer, business
Abstract

Background & Aims The role of hepatic resection for hepatocellular carcinoma (HCC) in different Barcelona Clinic Liver Cancer (BCLC) stages is controversial. We aimed at measuring the survival benefit of resection vs. non-surgical-therapies in each BCLC stage. Methods Using the ITA.LI.CA database, we identified 2090 BCLC A, B, and C HCC patients observed between 2000 and 2012: 550 underwent resection, 1046 loco-regional therapy (LRT), and 494 best supportive care (BSC). A multivariate log-logistic model was chosen to predict median survival (MS) after resection vs. MS after LRT or BSC. The results were expressed as net survival benefit of resection: (MS resection - MS LRT)/MS BSC. Results After stratifying for BCLC stage, the median net survival benefit of resection over LRT was: BCLC 0 = 62% (40%, 82%), A = 45% (13%, 65%), B = 46% (9%, 76%), C = -16% (-55%, 33%). Model for end-stage liver disease (MELD) score >9, Child B class, and performance status (PST) = 2 were the main risk factors for liver resection. 1181 Child A patients (57%) with MELD ≤9 and PST 9 or PST = 2 or Child B class), resection did not prove any survival benefit over LRT. Conclusions Resection could result in survival benefit over LRT for HCC patients regardless of their BCLC stage, provided that liver dysfunction (Child B or MELD >9) and PST >1 are absent.

Published
2014

32. Prognostic Prediction and Identification of Candidates for Salvage Liver Transplantation Among Patients With Early Hepatocellular Carcinoma

Author

Alessandro Cucchetti, Alessandro Vitale, F.A.C.G. Edoardo G. Giannini M.D., Giannini, Edoardo G, Cucchetti, Alessandro, and Vitale, Alessandro

Subjects
Male, Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, education, Prognostic prediction, Liver transplantation, Internal medicine, medicine, Carcinoma, Humans, Early Hepatocellular Carcinoma, Transplantation, Hepatology, business.industry, Medicine (all), Liver Neoplasms, medicine.disease, Liver Neoplasm, Catheter Ablation, Female, Surgery, business, Human
Abstract

Comment on Risk factors for exceeding the Milan criteria after successful radiofrequency ablation in patients with early-stage hepatocellular carcinoma. [Liver Transpl. 2014]

Published
2014
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