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31 results on '"GRAMENZI, ANNAGIULIA"'

1. Recalibrating survival prediction among patients receiving trans‐arterial chemoembolization for hepatocellular carcinoma

Author

Cucchetti, Alessandro, Giannini, Edoardo G., Mosconi, Cristina, Plaz Torres, Maria Corina, Pieri, Giulia, Farinati, Fabio, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Sacco, Rodolfo, Cabibbo, Giuseppe, Campani, Claudia, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati‐Baroni, Gianluca, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Sansone, Vito, Zoli, Marco, Azzaroli, Francesco, Trevisani, Franco, Biselli, Maurizio, Caraceni, Paolo, Gramenzi, Annagiulia, Rampoldi, Davide, Reggidori, Nicola, Santi, Valentina, Stefanini, Benedetta, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Tovoli, Francesco, Magalotti, Donatella, Dajti, Elton, Marasco, Giovanni, Ravaioli, Federico, Cappelli, Alberta, Golfieri, Rita, Renzulli, Matteo, Pelizzaro, Filippo, Penzo, Barbara, Marina Cela, Ester, Facciorusso, Antonio, Cacciato, Valentina, Casagrande, Edoardo, de Matthaeis, Nicoletta, Allegrini, Gloria, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Dell'Isola, Serena, Biasini, Elisabetta, Olivani, Andrea, Inno, Alessandro, Marchetti, Fabiana, Celsa, Ciro, Grova, Mauro, Stornello, Caterina, Busacca, Anita, Cammà, Calogero, Maria Rizzo, Giacomo Emanuele, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Napoli, Lucia, Bevilacqua, Vittoria, Berardinelli, Dante, Borghi, Alberto, Gardini, Andrea Casadei, Conti, Fabio, Dall'Aglio, Anna Chiara, Ercolani, Giorgio, Marra, Fabio, Di Bonaventura, Chiara, Gitto, Stefano, Adotti, Valentina, Coccoli, Pietro, Malerba, Antonio, Capasso, Mario, Morisco, Filomena, Oliveri, Filippo, Romagnoli, Veronica, Cucchetti, Alessandro, Giannini, Edoardo G., Mosconi, Cristina, Plaz Torres, Maria Corina, Pieri, Giulia, Farinati, Fabio, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Sacco, Rodolfo, Cabibbo, Giuseppe, Campani, Claudia, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati‐Baroni, Gianluca, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Sansone, Vito, Zoli, Marco, Azzaroli, Francesco, Trevisani, Franco, Biselli, Maurizio, Caraceni, Paolo, Gramenzi, Annagiulia, Rampoldi, Davide, Reggidori, Nicola, Santi, Valentina, Stefanini, Benedetta, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Tovoli, Francesco, Magalotti, Donatella, Dajti, Elton, Marasco, Giovanni, Ravaioli, Federico, Cappelli, Alberta, Golfieri, Rita, Renzulli, Matteo, Pelizzaro, Filippo, Penzo, Barbara, Marina Cela, Ester, Facciorusso, Antonio, Cacciato, Valentina, Casagrande, Edoardo, de Matthaeis, Nicoletta, Allegrini, Gloria, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Dell'Isola, Serena, Biasini, Elisabetta, Olivani, Andrea, Inno, Alessandro, Marchetti, Fabiana, Celsa, Ciro, Grova, Mauro, Stornello, Caterina, Busacca, Anita, Cammà, Calogero, Maria Rizzo, Giacomo Emanuele, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Napoli, Lucia, Bevilacqua, Vittoria, Berardinelli, Dante, Borghi, Alberto, Gardini, Andrea Casadei, Conti, Fabio, Dall'Aglio, Anna Chiara, Ercolani, Giorgio, Marra, Fabio, Di Bonaventura, Chiara, Gitto, Stefano, Adotti, Valentina, Coccoli, Pietro, Malerba, Antonio, Capasso, Mario, Morisco, Filomena, Oliveri, Filippo, and Romagnoli, Veronica

Subjects
Liver Cancer, Pre-TACE-Predict model, medicine.medical_specialty, business.industry, Trans-arterial chemoembolization, Pharmaceutical Science, hepatocellular carcinoma, medicine.disease, Gastroenterology, Complementary and alternative medicine, Internal medicine, Hepatocellular carcinoma, medicine, Pharmacology (medical), Trans arterial chemoembolization, business
Abstract

Background & Aims The Pre-TACE-Predict model was devised to assess prognosis of patients treated with trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). However, before entering clinical practice, a model should demonstrate that it performs a useful role. Methods We performed an independent external validation of the Pre-TACE model in a cohort that differs in setting and time period from the one that generated the original model. Data from 826 patients treated with TACE for naïve HCC (2008-2018) were used to assess calibration and discrimination of the Pre-TACE-Predict model. Results The four risk-categories identified by the Pre-TACE-Predict model had gradient monotonicity, with median survivals of 52.0, 36.2, 29.9, and 14.1 months respectively. However, predicted survivals systematically underestimated observed survivals (R2: 0.667). A recalibration was adopted maintaining fixed the prognostic index and modifying the baseline survival function. This resulted in an almost perfect calibration (R2: 0.995) in all the four risk categories. Cox regressions showed that aetiology and macrovascular invasion, included in the Pre-TACE-Predict model, had no prognostic impact in the present study population, and that coefficients for tumour size and multiplicity were overestimated. The c-index was similar to that of the m-HAP-III, but higher than those of HAP, m-HAP-II and the six-and-twelve models. Conclusions The recalibration of Pre-TACE-Predict model improved the estimation of survival probabilities of HCC patients treated with TACE. The highest discriminatory ability of the Pre-TACE-model in comparison to other available models, together with risk stratification and recalibration, makes it the best prognostic tool currently available for these patients.

Published
2021
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2. Monofocal hepatocellular carcinoma: How much does size matter?

Author

Pelizzaro, Filippo, Penzo, Barbara, Peserico, Giulia, Imondi, Angela, Sartori, Anna, Vitale, Alessandro, Cillo, Umberto, Giannini, Edoardo G., Forgione, Antonella, Ludovico Rapaccini, Gian, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Svegliati‐Baroni, Gianluca, Giuseppe Foschi, Francesco, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Trevisani, Franco, Farinati, Fabio, Biselli, Maurizio, Caraceni, Paolo, Garuti, Francesca, Gramenzi, Annagiulia, Neri, Andrea, Santi, Valentina, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Sansone, Vito, Tovoli, Francesco, Dajti, Elton, Marasco, Giovanni, Ravaioli, Federico, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Sammarco, Ambra, Cela, Ester Marina, Facciorusso, Antonio, Cacciato, Valentina, Casagrande, Edoardo, Moscatelli, Alessandro, Pellegatta, Gaia, de Matthaeis, Nicoletta, Allegrini, Gloria, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Missale, Gabriele, Inno, Alessandro, Marchetti, Fabiana, Busacca, Anita, Cammà, Calogero, Martino, Vincenzo Di, Emanuele Maria Rizzo, Giacomo, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Bevilacqua, Vittoria, Borghi, Alberto, Casadei Gardini, Andrea, Conti, Fabio, Dall'Aglio, Anna Chiara, Ercolani, Giorgio, Mirici, Federica, Campani, Claudia, Bonaventura, Chiara Di, Gitto, Stefano, Coccoli, Pietro, Malerba, Antonio, Guarino, Maria, Brunetto, Maurizia, Romagnoli, Veronica, Pelizzaro, Filippo, Penzo, Barbara, Peserico, Giulia, Imondi, Angela, Sartori, Anna, Vitale, Alessandro, Cillo, Umberto, Giannini, Edoardo G., Forgione, Antonella, Ludovico Rapaccini, Gian, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Svegliati‐Baroni, Gianluca, Giuseppe Foschi, Francesco, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Trevisani, Franco, Farinati, Fabio, Biselli, Maurizio, Caraceni, Paolo, Garuti, Francesca, Gramenzi, Annagiulia, Neri, Andrea, Santi, Valentina, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Sansone, Vito, Tovoli, Francesco, Dajti, Elton, Marasco, Giovanni, Ravaioli, Federico, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Sammarco, Ambra, Cela, Ester Marina, Facciorusso, Antonio, Cacciato, Valentina, Casagrande, Edoardo, Moscatelli, Alessandro, Pellegatta, Gaia, de Matthaeis, Nicoletta, Allegrini, Gloria, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Missale, Gabriele, Inno, Alessandro, Marchetti, Fabiana, Busacca, Anita, Cammà, Calogero, Martino, Vincenzo Di, Emanuele Maria Rizzo, Giacomo, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Bevilacqua, Vittoria, Borghi, Alberto, Casadei Gardini, Andrea, Conti, Fabio, Dall'Aglio, Anna Chiara, Ercolani, Giorgio, Mirici, Federica, Campani, Claudia, Bonaventura, Chiara Di, Gitto, Stefano, Coccoli, Pietro, Malerba, Antonio, Guarino, Maria, Brunetto, Maurizia, Romagnoli, Veronica, Giannini, Edoardo G, Svegliati-Baroni, Gianluca, for the Italica, Group, Pelizzaro F., Penzo B., Peserico G., Imondi A., Sartori A., Vitale A., Cillo U., Giannini E.G., Forgione A., Ludovico Rapaccini G., Di Marco M., Caturelli E., Zoli M., Sacco R., Cabibbo G., Marra F., Mega A., Morisco F., Gasbarrini A., Svegliati-Baroni G., Giuseppe Foschi F., Olivani A., Masotto A., Nardone G., Raimondo G., Azzaroli F., Vidili G., Oliveri F., Trevisani F., Farinati F., Biselli M., Caraceni P., Garuti F., Gramenzi A., Neri A., Santi V., Granito A., Muratori L., Piscaglia F., Sansone V., Tovoli F., Dajti E., Marasco G., Ravaioli F., Cappelli A., Golfieri R., Mosconi C., Renzulli M., Sammarco A., Cela E.M., Facciorusso A., Cacciato V., Casagrande E., Moscatelli A., Pellegatta G., de Matthaeis N., Allegrini G., Lauria V., Ghittoni G., Pelecca G., Chegai F., Coratella F., Ortenzi M., Missale G., Inno A., Marchetti F., Busacca A., Qabibboz G., Camma C., Martino V.D., Emanuele Maria Rizzo G., Franze M.S., Saitta C., Sauchella A., Bevilacqua V., Borghi A., Casadei Gardini A., Conti F., Dall'Aglio A.C., Ercolani G., Mirici F., Campani C., Bonaventura C.D., Gitto S., Coccoli P., Malerba A., Guarino M., Brunetto M., Romagnoli V., Rapaccini, Gian Ludovico, and Foschi, Francesco Giuseppe

Subjects
medicine.medical_specialty, Multivariate analysis, Carcinoma, Hepatocellular, Independent predictor, Gastroenterology, Resection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Overall survival, Hepatectomy, Humans, Staging system, Neoplasm Staging, Retrospective Studies, Settore MED/12 - Gastroenterologia, Hepatology, treatment, business.industry, Settore MED/09 - MEDICINA INTERNA, Liver Neoplasms, bclc staging system, monofocal hepatocellular carcinoma, medicine.disease, digestive system diseases, Survival benefit, Italy, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, liver resection, prognosis, 030211 gastroenterology & hepatology, business, Liver cancer, prognosi
Abstract

Background & Aims: According to the Barcelona Clinic Liver Cancer (BCLC) staging system, monofocal hepatocellular carcinoma (HCC) is classified as early (BCLC A) irrespective of its size, even though controversies still exist regarding staging and treatment of large tumours. We aimed at evaluating the appropriate staging and treatment for large (>5cm) monofocal (HCC). Methods: From the Italian Liver Cancer database, we selected 924 patients with small early monofocal HCC (2-5cm; SEM-HCC), 163 patients with larger tumours (>5cm; LEM-HCC) and 1048 intermediate stage patients (BCLC B). Results: LEM-HCC patients had a worse overall survival (OS) than SEM-HCC (31.0 vs 49.0months; P&nbsp

Published
2021

3. A meta-analysis of single HCV-untreated arm of studies evaluating outcomes after curative treatments of HCV-related hepatocellular carcinoma

Author

Cabibbo, Giuseppe, Petta, Salvatore, Barbã ra, Marco, Missale, Gabriele, Virdone, Roberto, Caturelli, Eugenio, Piscaglia, Fabio, Morisco, Filomena, Colecchia, Antonio, Farinati, Fabio, Giannini, Edoardo, Trevisani, Franco, Craxã¬, Antonio, Colombo, Massimo, Cammã , Calogero, Bucci, Laura, Zoli, Marco, Garuti, Francesca, Lenzi, Barbara, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Gramenzi, Annagiulia, Granito, Alessandro, Magalotti, Donatella, Serra, Carla, Negrini, Giulia, Napoli, Lucia, Salvatore, Veronica, Benevento, Francesca, Benvegnã¹, Luisa, Gazzola, Alessia, Murer, Francesca, Pozzan, Caterina, Vanin, Veronica, Moscatelli, Alessandro, Pellegatta, Gaia, Picciotto, Antonino, Savarino, Vincenzo, Ciccarese, Francesca, Del Poggio, Paolo, Olmi, Stefano, de Matthaeis, Nicoletta, Balsamo, Mariella Di Marco Claudia, Vavassori, Elena, Roselli, Paola, Dell’Isola, Serena, Ialungo, Anna Maria, Rastrelli, Elena, Attardo, Simona, Rossi, Margherita, Costantino, Andrea, Affronti, Andrea, Affronti, Marco, Mascari, Marta, Felder, Martina, Mega, Andrea, Gasbarrini, Antonio, Pompili, Maurizio, Rinninella, Emanuele, Sacco, Rodolfo, Mismas, Valeria, Foschi, Francesco Giuseppe, Dall’Aglio, Anna Chiara, Feletti, Valentina, Lanzi, Arianna, Cappa, Federica Mirici, Neri, Elga, Stefanini, Giuseppe Francesco, Tamberi, Stefano, Olivani, Andrea, Biasini, Elisabetta, Nardone, Gerardo, Guarino, Maria, Svegliati-Baroni, Gialuca, Ortolani, Alessio, Masotto, Alberto, Marchetti, Fabiana, Valerio, Matteo, Marra, Fabio, Aburas, Sami, Inghilesi, Andrea L, Cappelli, Alberta, Golfieri, Rita, Mosconi, MARIA CRISTINA, Renzulli, Matteo, Coccoli, Piero, Zamparelli, Marco Sanduzzi, Benvegnu', Luisa, Cabibbo, Giuseppe, Petta, Salvatore, Barbàra, Marco, Missale, Gabriele, Virdone, Roberto, Caturelli, Eugenio, Piscaglia, Fabio, Morisco, Filomena, Colecchia, Antonio, Farinati, Fabio, Giannini, Edoardo, Trevisani, Franco, Craxì, Antonio, Colombo, Massimo, Cammà, Calogero, Nardone, GERARDO ANTONIO PIO, Cabibbo, G., Petta, S., Barbara, M., Missale, G., Virdone, R., Caturelli, E., Piscaglia, F., Morisco, F., Colecchia, A., Farinati, F., Giannini, E., Trevisani, F., Craxi, A., Colombo, M., Camma, C., Bucci, L., Zoli, M., Garuti, F., Lenzi, B., Biselli, M., Caraceni, P., Cucchetti, A., Gramenzi, A., Granito, A., Magalotti, D., Serra, C., Negrini, G., Napoli, L., Salvatore, V., Benevento, F., Benvegnu, L., Gazzola, A., Murer, F., Pozzan, C., Vanin, V., Moscatelli, A., Pellegatta, G., Picciotto, A., Savarino, V., Ciccarese, F., Del Poggio, P., Olmi, S., de Matthaeis, N., Balsamo, M. D. M. C., Vavassori, E., Roselli, P., Dell'Isola, S., Ialungo, A. M., Rastrelli, E., Attardo, S., Rossi, M., Costantino, A., Affronti, A., Affronti, M., Mascari, M., Felder, M., Mega, A., Gasbarrini, A., Pompili, M., Rinninella, E., Sacco, R., Mismas, V., Foschi, F. G., Dall'Aglio, A. C., Feletti, V., Lanzi, A., Cappa, F. M., Neri, E., Stefanini, G. F., Tamberi, S., Olivani, A., Biasini, E., Nardone, G., Guarino, M., Svegliati-Baroni, G., Ortolani, A., Masotto, A., Marchetti, F., Valerio, M., Marra, F., Aburas, S., Inghilesi, A. L., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Coccoli, P., Zamparelli, M. S., Barbã ra, Marco, Craxã¬, Antonio, Cammã , Calogero, Bucci, Laura, Zoli, Marco, Garuti, Francesca, Lenzi, Barbara, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Gramenzi, Annagiulia, Granito, Alessandro, Magalotti, Donatella, Serra, Carla, Negrini, Giulia, Napoli, Lucia, Salvatore, Veronica, Benevento, Francesca, Benvegnã¹, Luisa, Gazzola, Alessia, Murer, Francesca, Pozzan, Caterina, Vanin, Veronica, Moscatelli, Alessandro, Pellegatta, Gaia, Picciotto, Antonino, Savarino, Vincenzo, Ciccarese, Francesca, Del Poggio, Paolo, Olmi, Stefano, de Matthaeis, Nicoletta, Balsamo, Mariella Di Marco Claudia, Vavassori, Elena, Roselli, Paola, Dellâ isola, Serena, Ialungo, Anna Maria, Rastrelli, Elena, Attardo, Simona, Rossi, Margherita, Costantino, Andrea, Affronti, Andrea, Affronti, Marco, Mascari, Marta, Felder, Martina, Mega, Andrea, Gasbarrini, Antonio, Pompili, Maurizio, Rinninella, Emanuele, Sacco, Rodolfo, Mismas, Valeria, Foschi, Francesco Giuseppe, Dallâ aglio, Anna Chiara, Feletti, Valentina, Lanzi, Arianna, Federica Mirici, Cappa, Neri, Elga, Stefanini, Giuseppe Francesco, Tamberi, Stefano, Olivani, Andrea, Biasini, Elisabetta, Nardone, Gerardo, Guarino, Maria, Svegliati-Baroni, Gialuca, Ortolani, Alessio, Masotto, Alberto, Marchetti, Fabiana, Valerio, Matteo, Marra, Fabio, Aburas, Sami, Inghilesi, Andrea L, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Coccoli, Piero, Zamparelli, Marco Sanduzzi, Camma', C., Benvegnã¹, L., Balsamo, M., Dell’Isola, S., Ialungo, A., Foschi, F., Dall’Aglio, A., Cappa, F., Stefanini, G., Inghilesi, A., and Zamparelli, M.

Subjects
Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, recurrence, Hepatitis C virus, medicine.medical_treatment, medicine.disease_cause, survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Adjuvant therapy, hepatocellular carcinoma, prognosis, recurrences, Humans, Survival analysis, Hepatology, business.industry, Liver Neoplasms, medicine.disease, Hepatitis C, 030220 oncology & carcinogenesis, Meta-analysis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business, Adjuvant, prognosi
Abstract

Background & Aims: Determining risk for recurrence or survival after curative resection or ablation in patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) is important for stratifying patients according to expected outcomes in future studies of adjuvant therapy in the era of direct-acting antivirals (DAAs). The aims of this meta-analysis were to estimate the recurrence and survival probabilities of HCV-related early HCC following complete response after potentially curative treatment and to identify predictors of recurrence and survival. Methods: Studies reporting time-dependent outcomes (HCC recurrence or death) after potentially curative treatment of HCV-related early HCC were identified in MEDLINE through May 2016. Data on patient populations and outcomes were extracted from each study by three independent observers and combined using a distribution-free summary survival curve. Primary outcomes were actuarial probabilities of recurrence and survival. Results: Eleven studies met the inclusion criteria. Pooled estimates of actuarial recurrence rates were 7.4% at 6months and 47.0% at 2years. Pooled estimates of actuarial survival rates were 79.8% at 3years and 58.6% at 5years. Heterogeneity among studies was highly significant for all outcomes. By univariate meta-regression analyses, lower serum albumin, randomized controlled trial study design and follow-up were independently associated with higher recurrence risk, whereas tumour size and alpha-foetoprotein levels were associated with higher mortality. Conclusions: This meta-analysis showed that recurrence risk and survival are extremely variable in patients with successfully treated HCV-related HCC, providing a useful benchmark for indirect comparisons of the benefits of DAAs and for a correct design of randomized controlled trials in the adjuvant setting.

Published
2017

4. Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma

Author

Giannini, Edoardo G, Moscatelli, Alessandro, Pellegatta, Gaia, Vitale, Alessandro, Farinati, Fabio, Ciccarese, Francesca, Piscaglia, Fabio, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Cabibbo, Giuseppe, Felder, Martina, Sacco, Rodolfo, Morisco, Filomena, Missale, Gabriele, Foschi, Francesco Giuseppe, Gasbarrini, Antonio, Baroni, Gianluca Svegliati, Virdone, Roberto, Masotto, Alberto, Trevisani, Franco, Bolondi, Luigi, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Gramenzi, Annagiulia, Magalotti, Donatella, Pecorelli, Anna, Serra, Carla, Venerandi, Laura, Gazzola, Alessia, Murer, Francesca, Pozzan, Caterina, Vanin, Veronica, Del Poggio, Paolo, Olmi, Stefano, Balsamo, Claudia, Vavassori, Elena, Benvegnu', Luisa, Capelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Bosco, Giulia, Roselli, Paola, Dell'Isola, Serena, Maria Ialungo, Anna, Rastrelli, Elena, Picciotto, Antonino, Savarino, Vincenzo, Mega, Andrea, Rinninella, Emanuele, Mismas, Valeria, Lanzi, Arianna, Cappa, Federica Mirici, Musetto, Alessandro, Neri, Elga, Stefanini, Giuseppe Francesco, Suzzi, Alessandra, Tamberi, Stefano, Triossi, Omero, Chiaramonte, Maria, Marchetti, Fabiana, Valerio, Matteo, Giannini, Edoardo G, Moscatelli, Alessandro, Pellegatta, Gaia, Vitale, Alessandro, Farinati, Fabio, Ciccarese, Francesca, Piscaglia, Fabio, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Cabibbo, Giuseppe, Felder, Martina, Sacco, Rodolfo, Morisco, Filomena, Missale, Gabriele, Foschi, Francesco Giuseppe, Gasbarrini, Antonio, Baroni, Gianluca Svegliati, Virdone, Roberto, Masotto, Alberto, Trevisani, Franco, Bolondi, Luigi, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Gramenzi, Annagiulia, Magalotti, Donatella, Pecorelli, Anna, Serra, Carla, Venerandi, Laura, Gazzola, Alessia, Murer, Francesca, Pozzan, Caterina, Vanin, Veronica, Del Poggio, Paolo, Olmi, Stefano, Balsamo, Claudia, Vavassori, Elena, Benvegnù, Luisa, Capelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Bosco, Giulia, Roselli, Paola, Dell'Isola, Serena, Maria Ialungo, Anna, Rastrelli, Elena, Picciotto, Antonino, Savarino, Vincenzo, Mega, Andrea, Rinninella, Emanuele, Mismas, Valeria, Lanzi, Arianna, Cappa, Federica Mirici, Musetto, Alessandro, Neri, Elga, Stefanini, Giuseppe Francesco, Suzzi, Alessandra, Tamberi, Stefano, Triossi, Omero, Chiaramonte, Maria, Marchetti, Fabiana, and Valerio, Matteo

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Prognosi, Aged, Aged, 80 and over, Female, Humans, Liver Neoplasms, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Young Adult, Gastroenterology, Intermediate stage, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, 80 and over, Prospective cohort study, Hepatology, business.industry, Medicine (all), Settore MED/09 - MEDICINA INTERNA, Hepatocellular, medicine.disease, Prospective Studie, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Neoplasm staging, Liver cancer, business, Human
Abstract

OBJECTIVES:The Barcelona Clinic Liver Cancer (BCLC) intermediate stage (BCLC B) includes a heterogeneous population of patients with hepatocellular carcinoma (HCC). Recently, in order to facilitate treatment decisions, a panel of experts proposed to subclassify BCLC B patients. In this study, we aimed to assess the prognostic capability of the BCLC B stage reclassification in a large cohort of patients with untreated HCC managed by the Italian Liver Cancer Group.METHODS:We assessed the prognosis of 269 untreated HCC patients observed in the period 1987-2012 who were reclassified according to the proposed subclassification of the BCLC B stage from stage B1 to stage B4. We evaluated and compared the survival of the various substages.RESULTS:Median survival progressively decreased from stage B1 (n=65, 24.2%: 25 months) through stages B2 (n=105, 39.0%: 16 months) and B3 (n=22, 8.2%: 9 months), to stage B4 (n=77, 28.6%: 5 months; P

Published
2016

5. The evolutionary scenario of hepatocellular carcinoma in Italy: an update

Author

Bucci, Laura, Garuti, Francesca, Lenzi, Barbara, Pecorelli, Anna, Farinati, Fabio, Giannini, Edoardo G., Granito, Alessandro, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cammà, Calogero, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Bernardi, Mauro, Trevisani, Franco, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Gramenzi, Annagiulia, Magalotti, Donatella, Napoli, Lucia, Negrini, Giulia, Piscaglia, Fabio, Serra, Carla, Tovoli, Francesco, Marafatto, Filippo, Murer, Francesca, Peserico, Giulia, Pozzan, Caterina, Vanin, Veronica, Moscatelli, Alessandro, Pellegatta, Gaia, Picciotto, Antonino, Savarino, Vincenzo, Poggio, Paolo Del, Olmi, Stefano, De Matthaeis, Nicoletta, Balsamo, Claudia, Vavassori, Elena, Roselli, Paola, Dell’Isola, Serena, Ialungo, Anna Maria, Rastrelli, Elena, Barcellona, Maria Rosa, Cabibbo, Giuseppe, Costantino, Andrea, Maida, Marcello, Affronti, Andrea, Mega, Andrea, Rinninella, Emanuele, Mismas, Valeria, Dall’Aglio, Anna Chiara, Feletti, Valentina, Lanzi, Arianna, Cappa, Federica Mirici, Neri, Elga, Stefanini, Giuseppe Francesco, Tamberi, Stefano, Biasini, Elisabetta, Porro, Emanuela, Guarino, Maria, Gemini, Stefano, Schiadà, Laura, Chiaramonte, Maria, Marchetti, Fabiana, Valerio, Matteo, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Coccoli, Piero, Zamparelli, Marco Sanduzzi, Aburas, Sami, Inghilesi, Andrea Lorenzo, Bucci, Laura, Garuti, Francesca, Lenzi, Barbara, Pecorelli, Anna, Farinati, Fabio, Giannini, Edoardo G, Granito, Alessandro, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cammà, Calogero, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, GERARDO ANTONIO PIO, Colecchia, Antonio, Bernardi, Mauro, Trevisani, Franco, Bucci, L, Garuti, F, Lenzi, B, Granito, A, Zoli, M, Colecchia, A, Bernardi, M, Trevisani, F, Biselli, M, Caraceni, P, Cucchetti, A, Gramenzi, A, Piscaglia, F., Bucci, L., Garuti, F., Lenzi, B., Pecorelli, A., Farinati, F., Giannini, E., Granito, A., Ciccarese, F., Rapaccini, G., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cammà, C., Virdone, R., Marra, F., Felder, M., Morisco, F., Benvegnù, L., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F., Missale, G., Masotto, A., Nardone, G., Colecchia, A., Bernardi, M., and Trevisani, F.

Subjects
Oncology, Male, Etiology, Databases, Factual, Radiofrequency ablation, medicine.medical_treatment, law.invention, 0302 clinical medicine, law, Epidemiology, epidemiology, hepatocellular carcinoma, survival, treatment, Hepatology, Aged, 80 and over, Surveillance, Liver Neoplasms, Middle Aged, Prognosis, Italy, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Catheter Ablation, 030211 gastroenterology & hepatology, Female, alpha-Fetoproteins, Liver cancer, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, 03 medical and health sciences, Young Adult, Age Distribution, Internal medicine, medicine, Humans, Sex Distribution, Aged, Neoplasm Staging, Retrospective Studies, Cirrhosi, business.industry, Cancer stage, Settore MED/09 - MEDICINA INTERNA, Cancer, medicine.disease, Surgery, Percutaneous ethanol injection, business
Abstract

Background and aims Epidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of etiology, presentation, management and prognosis of hepatocellular carcinoma in Italy during the last 15 years. Methods Retrospective analysis of the ITA.LI.CA (Italian Liver Cancer) database including 5192 hepatocellular carcinoma patients managed in 24 centers from 2000 to 2014. Patients were divided into three groups according to the date of cancer diagnosis (2000-2004, 2005-2009 and 2010-2014). Results The main results were: 1) progressive patient aging; 2) progressive expansion of non-viral cases and, namely, of “metabolic” hepatocellular carcinomas; 3) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semiannual) surveillance program; 4) favourable cancer stage migration; 4) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; 5) improved outcomes of ablative and transarterial treatments; 6) improved overall survival (adjusted for the lead time in surveyed patients), particularly after 2009, of both viral and non-viral patients presenting with an early or intermediate stage hepatocellular carcinoma. Conclusions During the last 15 years several etiological and clinical features of hepatocellular carcinoma patients have changed, as their management. The observed improvement of overall survival was due both to the wider use of semiannual surveillance, expanding the proportion of tumors that qualified for curative treatments, and to the improved outcome of locoregional treatments. This article is protected by copyright. All rights reserved.

Published
2017

6. Hepatocellular carcinoma recurrence in patients with curative resection or ablation: impact of HCV eradication does not depend on the use of interferon

Author

Petta, S., Cabibbo, G., Barbara, M., Attardo, S., Bucci, L., Farinati, F., Giannini, E. G., Tovoli, F., Ciccarese, F., Rapaccini, Gian Ludovico, Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Virdone, R., Marra, F., Felder, M., Morisco, F., Benvegnù, L., Gasbarrini, Antonio, Svegliati-Baroni, G., Foschi, F. G., Olivani, A., Masotto, A., Nardone, G., Colecchia, A., Persico, M., Boccaccio, V., Craxì, A., Bruno, S., Trevisani, F., Cammà, C, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Piscaglia, Fabio, Gramenzi, Annagiulia, Granito, Alessandro, Magalotti, Donatella, Serra, Carla, Negrini, Giulia, Napoli, L., Napoli, Lucia, Salvatore, Veronica, Benevento, Francesca, Gazzola, Alessia, Murer, Francesca, Pozzan, Caterina, Vanin, Veronica, Moscatelli, Alessandro, Pellegatta, Gaia, Picciotto, Antonino, Savarino, Vincenzo, Delpoggio, Paolo, Olmi, Stefano, De Matthaeis, Nicoletta, Balsamo, Claudia, Vavassori, Elena, Roselli, Paola, Dell’Isola, Serena, Ialungo, Anna Maria, Rastrelli, Elena, Rini, Francesca, Costantino, Andrea, Affronti, Andrea, Affronti, Marco, Mascari, Marta, Mega, Andrea, Pompili, Maurizio, Rinninella, Emanuele, Mismas, Valeria, Dall’Aglio, Anna Chiara, Feletti, Valentina, Lanzi, Arianna, Cappa, Federica Mirici, Neri, Elga, Stefanini, Giuseppe Francesco, Tamberi, Stefano, Biasini, Elisabetta, Missale, Gabriele, Guarino, Maria, Ortolani, Alessio, Chiaramonte, Maria, Marchetti, Fabiana, Valerio, Matteo, Aburas, Sami, Inghilesi, Andrea L., Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Coccoli, Piero, Zamparelli, Marco Sanduzzi, Petta, Salvatore, Cabibbo, Giuseppe, Barbara, Marco, Attardo, Simona, Bucci, Laura, Farinati, Fabio, Giannini, Edoardo G., Tovoli, Francesco, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Dimarco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Persico, Marcello, Boccaccio, Vincenzo, Craxì, Antonio, Bruno, Savino, Trevisani, Franco, Cammà, Calogero, Petta, S, Cabibbo, G, Barbara, M, Attardo, S, Bucci, L, Farinati, F, Giannini, E. G, Tovoli, F, Ciccarese, F, Rapaccini, G. L, Di Marco, M, Caturelli, E, Zoli, M, Borzio, F, Sacco, R, Virdone, R, Marra, F, Felder, M, Morisco, Filomena, Benvegnù, L, Gasbarrini, A, Svegliati Baroni, G, Foschi, F. G, Olivani, A, Masotto, A, Nardone, GERARDO ANTONIO PIO, Colecchia, A, Persico, M, Boccaccio, V, Craxì, A, Bruno, S, Trevisani, F, Cammà, C., DIPARTIMENTO DI MEDICINA SPECIALISTICA, DIAGNOSTICA E SPERIMENTALE, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, AREA MIN. 06 - Scienze mediche, Petta, S., Cabibbo, G., Barbara, M., Attardo, S., Bucci, L., Farinati, F., Giannini, E., Tovoli, F., Ciccarese, F., Rapaccini, G., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Virdone, R., Marra, F., Felder, M., Morisco, F., Benvegnã¹, L., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F., Olivani, A., Masotto, A., Nardone, G., Colecchia, A., Persico, M., Boccaccio, V., Craxi, A., Bruno, S., Trevisani, F., Camma', C., Biselli, M., Caraceni, P., Cucchetti, A., Domenicali, M., Piscaglia, F., Gramenzi, A., Granito, A., Magalotti, D., Serra, C., Negrini, G., Napoli, L., Salvatore, V., Benevento, F., Gazzola, A., Murer, F., Pozzan, C., Vanin, V., Moscatelli, A., Pellegatta, G., Picciotto, A., Savarino, V., Delpoggio, P., Olmi, S., Dematthaeis, N., Balsamo, C., Vavassori, E., Roselli, P., Dell’Isola, S., Ialungo, A., Rastrelli, E., Rini, F., Costantino, A., Affronti, A., Affronti, M., Mascari, M., Mega, A., Pompili, M., Rinninella, E., Mismas, V., Dall’Aglio, A., Feletti, V., Lanzi, A., Cappa, F., Neri, E., Stefanini, G., Tamberi, S., Biasini, E., Missale, G., Guarino, M., Ortolani, A., Chiaramonte, M., Marchetti, F., Valerio, M., Aburas, S., Inghilesi, A., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Coccoli, P., Zamparelli, M., Giannini, E.G., Rapaccini, G.L., Benvegnù, L., Foschi, F.G., Craxì, A., Cammà, C, the Italian Liver Cancer (ITALICA) Group [, Maurizio Biselli, Paolo Caraceni, Alessandro Cucchetti, Marco Domenicali, Fabio Piscaglia, Annagiulia Gramenzi, Alessandro Granito, Donatella Magalotti, Carla Serra, Giulia Negrini, Lucia Napoli, Veronica Salvatore, Francesca Benevento, ], Giannini, E. G., Rapaccini, G. L., Benvegnu, L., Foschi, F. G., Camma, C., Dell'Isola, S., Ialungo, A. M., Dall'Aglio, A. C., Cappa, F. M., Stefanini, G. F., Inghilesi, A. L., and Zamparelli, M. S.

Subjects
Liver Cirrhosis, Male, Cirrhosis, Databases, Factual, Gastroenterology, HCV-infected cirrhotic patients, hepatocellular carcinoma, HCC, sustained viral eradication, SVR, interferon, 0302 clinical medicine, Retrospective Studie, Pharmacology (medical), Prospective Studies, Prospective cohort study, Aged, 80 and over, Liver Neoplasms, virus diseases, Hepatitis C, Middle Aged, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Catheter Ablation, Interferon, 030211 gastroenterology & hepatology, Female, Liver cancer, Human, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Liver Cirrhosi, Antiviral Agents, Follow-Up Studie, 03 medical and health sciences, Internal medicine, medicine, Carcinoma, Early Hepatocellular Carcinoma, Humans, Aged, Retrospective Studies, Antiviral Agent, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, Retrospective cohort study, medicine.disease, digestive system diseases, Surgery, Prospective Studie, Interferons, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

none 48 no Background: In HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma (HCC), the time to HCC recurrence and the effects of sustained viral eradication (SVR) by interferon (IFN)-based or IFN-free regimens on HCC recurrence remain unclear. Aim: To perform an indirect comparison of time to recurrence (TTR) in patients with successfully treated early HCC and active HCV infection with those of patients with SVR by IFN-based and by IFN-free regimens. Methods: We evaluated 443 patients with HCV-related cirrhosis and Barcelona Clinic Liver Cancer Stage A/0 HCC who had a complete radiological response after curative resection or ablation. Active HCV infection was present in 328, selected from the Italian Liver Cancer group cohort; 58 patients had SVR achieved by IFN-free regimens after HCC cure, and 57 patients had SVR achieved by IFN-based regimens after HCC cure. Individual data of patients in the last two groups were extracted from available publications. Results: TTR by Kaplan–Meier curve was significantly lower in patients with active HCV infection compared with those with SVR both by IFN-free (P = 0.02) and by IFN-based (P < 0.001) treatments. TTR was similar in patients with SVR by IFN-free or by IFN-based (P = 0.49) strategies. Conclusion: In HCV-infected, successfully treated patients with early HCC, SVR obtained by IFN-based or IFN-free regimens significantly reduce tumour recurrence without differences related to the anti-viral strategy used. Petta, S.; Cabibbo, G.; Barbara, M.; Attardo, S.; Bucci, L.; Farinati, F.; Giannini, E.G.; Tovoli, F.; Ciccarese, F.; Rapaccini, G.L.; Di Marco, M.; Caturelli, E.; Zoli, M.; Borzio, F.; Sacco, R.; Virdone, R.; Marra, F.; Felder, M.; Morisco, F.; Benvegnù, L.; Gasbarrini, A.; Svegliati-Baroni, G.; Foschi, F.G.; Olivani, A.; Masotto, A.; Nardone, G.; Colecchia, A.; Persico, M.; Boccaccio, V.; Craxì, A.; Bruno, S.; Trevisani, F.; Cammà, C; the Italian Liver Cancer (ITALICA) Group [ ; Maurizio Biselli; Paolo Caraceni; Alessandro Cucchetti; Marco Domenicali; Fabio Piscaglia; Annagiulia Gramenzi; Alessandro Granito; Donatella Magalotti; Carla Serra; Giulia Negrini; Lucia Napoli; Veronica Salvatore; Francesca Benevento;] Petta, S.; Cabibbo, G.; Barbara, M.; Attardo, S.; Bucci, L.; Farinati, F.; Giannini, E.G.; Tovoli, F.; Ciccarese, F.; Rapaccini, G.L.; Di Marco, M.; Caturelli, E.; Zoli, M.; Borzio, F.; Sacco, R.; Virdone, R.; Marra, F.; Felder, M.; Morisco, F.; Benvegnù, L.; Gasbarrini, A.; Svegliati-Baroni, G.; Foschi, F.G.; Olivani, A.; Masotto, A.; Nardone, G.; Colecchia, A.; Persico, M.; Boccaccio, V.; Craxì, A.; Bruno, S.; Trevisani, F.; Cammà, C; the Italian Liver Cancer (ITALICA) Group [ ; Maurizio Biselli; Paolo Caraceni; Alessandro Cucchetti; Marco Domenicali; Fabio Piscaglia; Annagiulia Gramenzi; Alessandro Granito; Donatella Magalotti; Carla Serra; Giulia Negrini; Lucia Napoli; Veronica Salvatore; Francesca Benevento;]

Published
2017

7. Yttrium-90 radioembolization vs sorafenib for intermediate-locally advanced hepatocellular carcinoma: a cohort study with propensity score analysis

Author

GRAMENZI, ANNAGIULIA, GRANITO, ALESSANDRO, CUCCHETTI, ALESSANDRO, BOLONDI, LUIGI, BERNARDI, MAURO, TREVISANI, FRANCO, Golfieri R, Mosconi C, Cappelli A, Marinelli S, Pettinato C, Erroi V, Fiumana S, on behalf of BLOG, Gramenzi A, Golfieri R, Mosconi C, Cappelli A, Granito A, Cucchetti A, Marinelli S, Pettinato C, Erroi V, Fiumana S, Bolondi L, Bernardi M, Trevisani F, and on behalf of BLOG (Bologna Liver Oncology Group).

Subjects
Male, Niacinamide, Oncology, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Tare weight, medicine.medical_treatment, Antineoplastic Agents, Liver transplantation, ADVANCED STAGE, Cause of Death, Internal medicine, medicine, Humans, Yttrium Radioisotopes, HEPATOCELLULAR CARCINOMA, Propensity Score, Aged, Retrospective Studies, Aged, 80 and over, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Middle Aged, medicine.disease, Embolization, Therapeutic, digestive system diseases, BCLC Stage, Treatment, Transplantation, SORAFENIB, Italy, Case-Control Studies, Hepatocellular carcinoma, Female, Liver function, Liver cancer, business, TRANSARTERIAL RADIOTHERAPY, medicine.drug
Abstract

Background & Aims: Sorafenib and transarterial 90 Y-radioembolization(TARE) are possible treatments for Barcelona Clinic Liver Cancer (BCLC)intermediate-advanced stage hepatocellular carcinoma (HCC). No studydirectly comparing sorafenib and TARE is currently available. This single-centre retrospective study compares the outcomes achieved with sorafeniband TARE in HCC patients potentially amenable to either therapy. Meth-ods: Seventy-four sorafenib (71 ± 10 years, male 87%, BCLC B/C 53%/47%)and 63 TARE HCC patients (66 ± 9 years, male 79%, BCLC B/C 41%/59%)were included based on the following criteria: Child–Pugh class A/B, perfor-mance status ≤1, HCC unfit for other effective therapies, no metastases andno previous systemic chemotherapy. Results: Median overall survivals of thetwo groups were comparable, being 14.4 months (95% CI: 4.3–24.5) in so-rafenib and 13.2 months (95% CI: 6.1–20.2) in TARE patients, with 1-, 2-and 3-year survival rates of 52.1%, 29.3% and 14.7% vs 51.8%, 27.8% and21.6% respectively. Two TARE patients underwent liver transplantation aftersuccessful down-staging. To minimize the impact of confounding factors onsurvival analysis, propensity model matched 32 patients of each group formedian age, tumour gross pathology and the independent prognostic factors(portal vein thrombosis, performance status, Model for End Liver Disease).Even after matching, the median survival did not differ between sorafenib(13.1 months; 95% CI: 1.2–25.9) and TARE patients (11.2 months; 95% CI:6.7–15.7), with comparable 1-, 2- and 3-year survival rates. Conclusions: Incirrhotic patients with intermediate-advanced or not-otherwise-treatableHCC, sorafenib and TARE provide similar survivals. Down-staging allowingliver transplantation only occurred after TARE.Hepatocellular carcinoma (HCC) is the third most com-mon cause of cancer-related death worldwide, and theleading cause of mortality of cirrhotic patients (1, 2).Several curative or palliative treatments are currentlyavailable, according to the cancer burden and liver func-tion. For this choice, American and European guidelinessuggest the use of the Barcelona Clinic Liver Cancer(BCLC) classification which links tumour stage to treat-ment in an evidence-based fashion (3, 4). Only 30–40%of HCCs are diagnosed at an early stage, and advancedstage HCCs (BCLC stage C) account for a large propor-tion of the remaining cases (5). Moreover, despite treat-ment, most early HCCs eventually progress to theadvanced stage. The recommended treatment for thesetumours is sorafenib, because two phase III clinical trialsproved that this treatment prolongs the survival ofChild–Pugh A patients with advanced HCC (6, 7).However, the tolerability of sorafenib is suboptimal, andin a post-marketing multicentre study, it was down-dosed in more than half of the patients and interruptedin 45% of cases, because of severe adverse effects (AEs)or liver function deterioration (8).As more than two-thirds of patients with advancedHCC die from intrahepatic tumour progression or liverfailure, rather than from metastatic disease (9–12), aneffective and well-tolerated locoregional treatment could

Published
2014
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8. Comparison between alcohol- and hepatitis C virus-related hepatocellular carcinoma: clinical presentation, treatment and outcome

Author

BUCCI, LAURA, GARUTI, FRANCESCA, LENZI, BARBARA, PISCAGLIA, FABIO, ZOLI, MARCO, BERNARDI, MAURO, TREVISANI, FRANCO, BOLONDI, LUIGI, BISELLI, MAURIZIO, CARACENI, PAOLO, CUCCHETTI, ALESSANDRO, DOMENICALI, MARCO, GRAMENZI, ANNAGIULIA, Camelli, V, Farinati, F, Giannini, E, Ciccarese, F, Rapaccini, G, Di Marco, M, Caturelli, E, Borzio, F, Sacco, R, Maida, M, Felder, M, Morisco, F, Gasbarrini, A, Gemini, S, Foschi, F, Missale, G, Masotto, A, Affronti, A, Italian Liver Cancer Group, Bucci, L., Garuti, F., Camelli, V., Lenzi, B., Farinati, F., Giannini, E. G., Ciccarese, F., Piscaglia, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Maida, M., Felder, M., Morisco, F., Gasbarrini, A., Gemini, S., Foschi, F. G., Missale, G., Masotto, A., Affronti, A., Bernardi, M., Trevisani, F, Olmi, S, on behalf of Italian Liver Cancer, (ITA. LI. CA) Group., Bucci, L, Garuti, F, Camelli, V, Lenzi, B, Farinati, F, Giannini, E, Ciccarese, F, Piscaglia, F, Rapaccini, G, Di Marco, M, Caturelli, E, Zoli, M, Borzio, F, Sacco, R, Maida, M, Felder, M, Morisco, F, Gasbarrini, A, Gemini, S, Foschi, F, Missale, G, Masotto, A, Affronti, A, Bernardi, M, Italian Liver Cancer (ITA.LI.CA.) Group, Bolondi, L, Biselli, M, Caraceni, P, Cucchetti, A, Domenicali, M, Gramenzi, A, Giannini, E. G, Rapaccini, G. L, Morisco, Filomena, Foschi, F. G, and Trevisani, F.

Subjects
Male, Sex Factor, Gastroenterology, Hepatitis, 0302 clinical medicine, alcoholic cirrhosi, Liver Function Tests, Retrospective Studie, Risk Factors, Esophageal and Gastric Varice, 80 and over, Age Factor, Pharmacology (medical), Age Factors, Aged, Aged, 80 and over, Carcinoma, Hepatocellular, Esophageal and Gastric Varices, Female, Hepatitis C, Hepatitis, Alcoholic, Humans, Liver Neoplasms, Middle Aged, Neoplasm Staging, Prognosis, Proportional Hazards Models, Retrospective Studies, Sex Factors, Treatment Outcome, Venous Thrombosis, alpha-Fetoproteins, Medicine (all), medicine.diagnostic_test, Liver Function Test, Alcoholic, Liver Neoplasm, Hepatocellualr carinoma, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, epidemiology, 030211 gastroenterology & hepatology, Liver cancer, Viral hepatitis, Human, medicine.medical_specialty, Prognosi, 03 medical and health sciences, Internal medicine, medicine, Venous Thrombosi, Hepatology, business.industry, Risk Factor, Carcinoma, Cancer, Hepatocellular, medicine.disease, digestive system diseases, BCLC Stage, Proportional Hazards Model, Liver function, business, Liver function tests, HCV-related cirrhosi
Abstract

Summary Background Hepatitis C virus (HCV) and alcohol abuse are the main risk factors for hepatocellular carcinoma (HCC) in Western countries. Aim To investigate the role of alcoholic aetiology on clinical presentation, treatment and outcome of HCC as well as on each Barcelona Clinic Liver Cancer (BCLC) stage, as compared to HCV-related HCCs. Methods A total of 1642 HCV and 573 alcoholic patients from the Italian Liver Cancer (ITA.LI.CA) database, diagnosed with HCC between January 2000 and December 2012 were compared for age, gender, type of diagnosis, tumour burden, portal vein thrombosis (PVT), oesophageal varices, liver function tests, alpha-fetoprotein, BCLC, treatment and survival. Aetiology was tested as predictor of survival in multivariate Cox regression models and according to HCC stages. Results Cirrhosis was present in 96% of cases in both groups. Alcoholic patients were younger, more likely male, with HCC diagnosed outside surveillance, in intermediate/terminal BCLC stage and had worse liver function. After adjustment for the lead-time, median (95% CI) overall survival (OS) was 27.4 months (21.5–33.2) in alcoholic and 33.6 months (30.7–36.5) in HCV patients (P = 0.021). The prognostic role of aetiology disappeared when survival was assessed in each BCLC stage and in the Cox regression multivariate models. Conclusions Alcoholic aetiology affects survival of HCC patients through its negative effects on secondary prevention and cancer presentation but not through a greater cancer aggressiveness or worse treatment result. In fact, survival adjusted for confounding factors was similar in alcoholic and HCV patients.

Published
2015

9. Prognosis of untreated hepatocellular carcinoma

Author

Giannini EG, Farinati F, Ciccarese F, Rapaccini GL, Di Marco M, Benvegnù L, Caturelli E, Borzio F, Chiaramonte M, Italian Liver Cancer group […, Garuti F, Lenzi B, Magalotti D, Serra C, BOLONDI, LUIGI, ZOLI, MARCO, TREVISANI, FRANCO, BERNARDI, MAURO, BISELLI, MAURIZIO, CARACENI, PAOLO, CUCCHETTI, ALESSANDRO, DOMENICALI, MARCO, GRAMENZI, ANNAGIULIA, PISCAGLIA, FABIO, Giannini EG, Farinati F, Ciccarese F, Pecorelli A, Rapaccini GL, Di Marco M, Benvegnù L, Caturelli E, Zoli M, Borzio F, Chiaramonte M, Trevisani F, Italian Liver Cancer (ITA.LI.CA) group […, Bernardi M, Biselli M, Caraceni P, Cucchetti A, Domenicali M, Garuti F, Gramenzi A, Lenzi B, Magalotti D, Piscaglia F, Serra C, and …]

Subjects
Male, medicine.medical_specialty, Cirrhosis, PROGNOSIS, Carcinoma, Hepatocellular, Settore MED/12 - GASTROENTEROLOGIA, Gastroenterology, Cohort Studies, Internal medicine, Carcinoma, medicine, Humans, Decompensation, HEPATOCELLULAR CARCINOMA, Cause of death, Aged, Neoplasm Staging, Aged, 80 and over, Hepatology, business.industry, CIRRHOISIS, Liver Neoplasms, Middle Aged, medicine.disease, BCLC Stage, Surgery, Italy, Hepatocellular carcinoma, Multivariate Analysis, SURVIVAL, Female, Liver cancer, business
Abstract

The prognosis of untreated patients with hepatocellular carcinoma (HCC) is heterogeneous, and survival data were mainly obtained from control arms of randomized studies. Clinical practice data on this topic are urgently needed, so as to help plan studies and counsel patients. We assessed the prognosis of 600 untreated patients with HCC managed by the Italian Liver Cancer Group. Prognosis was evaluated by subdividing patients according to the Barcelona Clinic Liver Cancer (BCLC) classification. We also assessed the main demographic, clinical, and oncological determinants of survival in the subgroup of patients with advanced HCC (BCLC C). Advanced (BCLC C: n = 138; 23.0%) and end-stage HCC (BCLC D; n = 210; 35.0%) represented the majority of patients. Overall median survival was 9 months, and the principal cause of death was tumor progression (n = 279; 46.5%). Patients' median survival progressively and significantly decreased as BCLC stage worsened (BCLC 0: 38 months; BCLC A: 25 months; BCLC B: 10 months; BCLC C: 7 months; BCLC D: 6 months; P 3) HCC (HR = 1.79; 95% CI = 1.21-2.63; P = 0.003) were independent predictors of survival in patients with advanced HCC (BCLC C). CONCLUSION: BCLC adequately predicts the prognosis of untreated HCC patients. In untreated patients with advanced HCC, female gender, clinical decompensation of cirrhosis, and multinodular tumor are independent prognostic predictors and should be taken into account for patient stratification in future therapeutic studies.

Published
2015

10. BCLC stage B hepatocellular carcinoma and transcatheter arterial chemoembolization: a 20-year survey by the Italian Liver Cancer group

Author

Farinati F., Vanin V., Giacomin A., Pozzan C., Cillo U., Vitale A., Di Nolfo A.M., Del Poggio P., Benvegnu' L., Rapaccini G., Borzio F., Giannini E.G., Caturelli E., Italian Liver Cancer group […, ZOLI, MARCO, TREVISANI, FRANCO, BERNARDI, MAURO, BISELLI, MAURIZIO, CARACENI, PAOLO, DOMENICALI, MARCO, ERROI, VIRGINIA, FRIGERIO, MARTA, GRAMENZI, ANNAGIULIA, LENZI, BARBARA, CUCCHETTI, ALESSANDRO, Farinati F., Vanin V., Giacomin A., Pozzan C., Cillo U., Vitale A., Di Nolfo AM., Del Poggio P., Benvegnu' L., Rapaccini G., Zoli M., Borzio F., Giannini EG., Caturelli E., Trevisani F, Italian Liver Cancer (ITA.LI.CA) group […, Bernardi M., Biselli M., Caraceni P., Domenicali M., Erroi V., Frigerio M., Gramenzi A., Lenzi B., Cucchetti A, and …]

Subjects
medicine.medical_specialty, Carcinoma, Hepatocellular, Kaplan-Meier Estimate, Gastroenterology, Internal medicine, medicine, Humans, HEPATOCELLULAR CARCINOMA, Chemoembolization, Therapeutic, Stage (cooking), Transcatheter arterial chemoembolization, Neoplasm Staging, Retrospective Studies, Hepatology, BCLC Stage B Hepatocellular Carcinoma, business.industry, Liver Neoplasms, Prognosis, medicine.disease, BCLC Stage, Log-rank test, BCLC, Italy, TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION, Hepatocellular carcinoma, treatment outcome, Guideline Adherence, Liver cancer, Varices, business
Abstract

Background & Aims Significant proportion of Hepatocellular Carcinoma (HCC) cases are diagnosed in stage B of Barcelona Clinic Liver Cancer (BCLC) algorithm, in which the standard of care is Transcatheter Arterial ChemoEmbolization (TACE). We aimed to ascertain adherence to current guidelines, survival and prognostic factors in BCLC stage B patients. Methods From 3027 HCC cases recruited from 1986 to 2008 by the Italian Liver Cancer group (2430 with data allowing a correct allocation in the BCLC system), a retrospective analysis was conducted on those diagnosed in BCLC stage B (405 patients, 17%). Statistics were performed with Kaplan–Meier (log rank) method and Cox multivariate analysis. Results Median overall survival in BCLC stage B patients was 25 months (Confidence Interval - C.I. - 22–28 months) with a 5-year survival of 18%. Child–Pugh class, oesophageal varices and Alpha-foetoprotein (AFP) were the independent predictors of survival. TACE was applied in 40% of cases and did not offer the longest survival in comparison with surgical or percutaneous treatments (median 27 months vs. 37 and 36 months, respectively) (P

Published
2015

11. Correlation between LDH levels and response to sorafenib in HCC patients: an analysis of the ITA.LI.CA database

Author

Sacco, Rodolfo, Mismas, Valeria, Granito, Alessandro, Musettini, Gianna, Masi, Gianluca, Caparello, Chiara, Vivaldi, Caterina, Felder, Martina, Bresci, Giampaolo, Fornaro, Lorenzo, Trevisani, Franco, Bernardi, Mauro, Bolondi, Luigi, Piscaglia, Fabio, Zoli, Marco, Biselli, Maurizio, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Frigerio, Marta, Erroi, Virginia, Garuti, Francesca, Gramenzi, Annagiulia, Lenzi, Barbara, Magalotti, Donatella, Pecorelli, Anna, Venerandi, Laura, Farinati, Fabio, Giacomin, Anna, Vanin, Veronica, Pozzan, Caterina, Maddalo, Gemma, Ciccarese, Francesca, Del Poggio, Paolo, Olmi, Stefano, Di Marco, Mariella, Balsamo, Claudia, Di Nolfo, Maria Anna, Vavassori, Elena, Alberti, Alfredo, Benvegnã¹, Luisa, Gatta, Angelo, Gios, Maurizio, Golfieri, Rita, Giampalma, Emanuela, Mosconi, Cristina, Renzulli, Matteo, Rapaccini, Gian Lodovico, Bosco, Giulia, Caturelli, Eugenio, Roselli, Paola, Dell’isola, Serena, Ialungo, Anna Maria, Giannini, Edoardo G., Risso, Domenico, Marenco, Simona, Bruzzone, Linda, Savarino, Vincenzo, Picciotto, Antonino, Chiaramonte, Maria, Cabibbo, Giuseppe, Cammã , Calogero, Maida, Marcello, Di Martino, Arezia, Barcellona, Maria Rosa, Mega, Andrea, Gasbarrini, Antonio, Rinninella, Emanuele, Rotella, Virginia, Ginanni, Barbara, Foschi, Francesco Giuseppe, Lanzi, Arianna, Stefanini, Giuseppe Francesco, Dall’aglio, Anna Chiara, Cappa, Federica Mirici, Neri, Elga, Bassi, Paolo, Zanotti, Miriam, Missale, Gabriele, Biasini, Elisabetta, Porro, Emanuela, Morisco, Filomena, Guarino, Maria, Baroni, Gianluca Svegliati, Schiadã , Laura, Gemini, Stefano, Borzio, Francesco, Virdone, Roberto, Rodolfo Sacco, Valeria Misma, Alessandro Granito, Gianna Musettini, Gianluca Masi, Chiara Caparello, Caterina Vivaldi, Martina Felder, Giampaolo Bresci, Lorenzo Fornaro, for the Italian Liver Cancer (ITA.LI.CA) group: [.., Franco Trevisani, Mauro Bernardi, Luigi Bolondi, Fabio Piscaglia, Marco Zoli, Maurizio Biselli, Paolo Caraceni, Alessandro Cucchetti, Marco Domenicali, Marta Frigerio, Virginia Erroi, Francesca Garuti, Annagiulia Gramenzi, Barbara Lenzi, Donatella Magalotti, Anna Pecorelli, Laura Venerandi, Rita Golfieri, Emanuela Giampalma, Cristina Mosconi, Matteo Renzulli, and ]

Subjects
Oncology, Male, Pathology, Cancer Research, Clinical Biochemistry, Drug Resistance, L-Lactate dehydrogenase, Biomarkers, HCC, LDH, Sorafenib, Aged, Antineoplastic Agents, Biomarkers, Tumor, Carcinoma, Hepatocellular, Drug Resistance, Neoplasm, Female, Humans, Kaplan-Meier Estimate, L-Lactate Dehydrogenase, Liver Neoplasms, Middle Aged, Niacinamide, Phenylurea Compounds, ROC Curve, Retrospective Studies, Treatment Outcome, 2734, Antineoplastic Agent, Retrospective Studie, Neoplasm, Tumor, Liver Neoplasm, Hepatocellular carcinoma, Human, medicine.drug, Phenylurea Compound, medicine.medical_specialty, Sorafenib treatment, Pathology and Forensic Medicine, Text mining, Internal medicine, medicine, Carcinoma, neoplasms, business.industry, Retrospective cohort study, Hepatocellular, Biomarker, medicine.disease, digestive system diseases, business
Abstract

Background Lactate dehydrogenase (LDH) is a predictor of clinical outcome in hepatocellular carcinoma (HCC) patients. However, its predictive role in the clinical outcomes of sorafenib treatment has been poorly documented. The correlation between LDH levels and clinical outcomes in HCC patients treated with sorafenib and included in the nationwide Italian database ITA.LI.CA was investigated here. Patients and Methods The ITA.LI.CA database contains data for 5,136 HCC patients. All patients treated with sorafenib treatment and with available LDH values were considered. Overall survival (OS) and time to progression (TTP) were compared in patients with LDH levels above and below a defined threshold, determined through an ROC analysis. An explorative analysis investigated the relationship between the variation of LDH levels during treatment and response to sorafenib. Results Baseline LDH levels were available for 97 patients. The most accurate cutoff value for LDH concentration was 297 U/L. Patients with LDH values above (n=45) and below (n=52) this threshold showed equal OS (12.0 months) and TTP (4.0 months) values. Data on LDH levels during sorafenib treatment were reported for 10 patients. LDH values decreased in 3 patients (mean difference = -219 U/L) who also reported a prolonged OS and TTP versus those with unmodified/increased LDH (OS: NE (not evaluated) vs. 8.0 months, p=0.0083; TTP: 19.0 vs. 3.0 months, p=0.008). Conclusions The clinical benefits of sorafenib do not seem to be influenced by baseline LDH. According to the results of an explorative analysis, however, a decreased LDH concentration during sorafenib might be associated with improved clinical outcomes.

Published
2015

12. 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

13. Influence of clinically significant portal hypertension on survival after hepatic resection for hepatocellular carcinoma in cirrhotic patients

Author

Edoardo G. Giannini, Vincenzo Savarino, Fabio Farinati, Francesca Ciccarese, Gianludovico Rapaccini, Mariella Di Marco, Luisa Benvegnu, Franco Borzio, Eugenio Caturelli, Maria Chiaramonte, The Italian Liver Cancer group [. . ., Virginia Erroi, Donatella Magalotti, Sabina Olmi, Emanuela Giampalma, Rita Golfieri, DOMENICALI, MARCO, ZOLI, MARCO, TREVISANI, FRANCO, BERNARDI, MAURO, BISELLI, MAURIZIO, CASSINI, ROMINA, CARACENI, PAOLO, CUCCHETTI, ALESSANDRO, GRAMENZI, ANNAGIULIA, RAVAIOLI, MATTEO, BALSAMO, CLAUDIA, MOSCONI, CRISTINA, RENZULLI, MATTEO, ROSELLI, PAMELA, RISSO, DAVIDE, BOSCO, GIOVANNA, Edoardo G. Giannini, Vincenzo Savarino, Fabio Farinati, Francesca Ciccarese, Gianludovico Rapaccini, Mariella Di Marco, Luisa Benvegnu, Marco Zoli, Franco Borzio, Eugenio Caturelli, Maria Chiaramonte, Franco Trevisani, The Italian Liver Cancer (ITA.LI.CA) group [.., Mauro Bernardi, Maurizio Biselli, Romina Cassini, Paolo Caraceni, Alessandro Cucchetti, Virginia Erroi, Annagiulia Gramenzi, Donatella Magalotti, Matteo Ravaioli, Sabina Olmi, Claudia Balsamo, Emanuela Giampalma, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Pamela Roselli, Davide Risso, Giovanna Bosco, ]., Giannini, E. G., Savarino, V., Farinati, F., Ciccarese, F., Rapaccini, G., Marco, M. D., Benvegnu, L., Zoli, M., Borzio, F., Caturelli, E., Chiaramonte, M., Trevisani, F, Olmi, S, and on behalf of Italian Liver Cancer, (ITA. LI. CA) group.

Subjects
Thrombocytopaenia, Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Survival, Hepatocellular carcinoma, Hepatic resection, Portal venous pressure, Hepatic venous pressure gradient, Portal hypertensive gastropathy, hepatic resection, Gastroenterology, Internal medicine, Hypertension, Portal, Hepatectomy, Humans, Medicine, HEPATOCELLULAR CARCINOMA, Portal hypertension, Aged, Retrospective Studies, Hepatology, Platelet Count, business.industry, Liver Neoplasms, portal hypertension, Middle Aged, Gastric varices, Prognosis, medicine.disease, Survival Analysis, digestive system diseases, Oesophageal varices, Italy, Surgery, Female, business, Liver cancer
Abstract

Background: The role of clinically significant portal hypertension on the prognosis of cirrhotic patients undergoing hepatic resection for hepatocellular carcinoma (HCC) is debated. Aims: In this study, our aim was to assess the role of clinically significant portal hypertension after hepatic resection for HCC in patients with cirrhosis. Methods: We assessed the prognostic role of the presence of clinically significant portal hypertension (oesophageal/gastric varices/portal hypertensive gastropathy or a platelet count 100 vs 86 months, P = 0.742). Conclusions: Presence of clinically significant portal hypertension has no influence on survival of patients with well-compensated cirrhosis undergoing hepatic resection for HCC. © 2013 John Wiley & Sons A/S.

Published
2013

14. Alpha-fetoprotein has no prognostic role in small hepatocellular carcinoma identified during surveillance in compensated cirrhosis

Author

Giannini, EG, Marenco, S, Borgonovo, G, Savarino, V, Farinati, F, Del Poggio, P, Rapaccini, GL, Di Nolfo, MA, Benvegnu, L, ZOLI, MARCO, Borzio, F, Caturelli, E, Chiaramonte, M, TREVISANI, FRANCO, Italian Liver Canc ITA LI CA Grp [. . ., BERNARDI, MAURO, BISELLI, MAURIZIO, CASSINI, ROMINA, CARACENI, PAOLO, DOMENICALI, MARCO, Erroi V, FRIGERIO, MARTA, GRAMENZI, ANNAGIULIA, Lenzi B, Magalotti D, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Giacomin A, Vanin V, Pozzan C, Maddalo G, RAVAIOLI, MATTEO, CUCCHETTI, ALESSANDRO, Giampalma E, Golfieri R, MOSCONI, CRISTINA, RENZULLI, MATTEO, Ghittoni G, Roselli P, Bosco G, Giannini, EG, Marenco, S, Borgonovo, G, Savarino, V, Farinati, F, Del Poggio, P, Rapaccini, GL, Di Nolfo, MA, Benvegnu, L, Zoli, M, Borzio, F, Caturelli, E, Chiaramonte, M, Trevisani, F, Italian Liver Canc ITA LI CA Grp [.., Bernardi M, Biselli M, Cassini R, Caraceni P, Domenicali M, Erroi V, Frigerio M, Gramenzi A, Lenzi B, Magalotti D, Balsamo C, Di Marco M, Vavassori E, Gilardoni L, Mattiello M, Alberti A, Gatta A, Gios M, Giacomin A, Vanin V, Pozzan C, Maddalo G, Ravaioli M, Cucchetti A, Giampalma E, Golfieri R, Mosconi C, Renzulli M, Ghittoni G, Roselli P, Bosco G, and ].

Subjects
Liver Cirrhosis, Male, Cirrhosis, IMPACT, medicine.medical_treatment, MULTICENTER, Kaplan-Meier Estimate, Liver transplantation, Gastroenterology, RECOMMENDATIONS, Cohort Studies, Aged, 80 and over, Biopsy, Needle, Liver Neoplasms, ASSOCIATION, Middle Aged, Prognosis, LIVER-TRANSPLANTATION, Immunohistochemistry, Hepatocellular carcinoma, SURVIVAL, Female, alpha-Fetoproteins, Liver cancer, medicine.medical_specialty, Carcinoma, Hepatocellular, RESECTION, Risk Assessment, Sensitivity and Specificity, Statistics, Nonparametric, Internal medicine, Biomarkers, Tumor, medicine, Hepatectomy, Humans, Neoplasm Invasiveness, Aged, Neoplasm Staging, Retrospective Studies, Tumor marker, Hepatology, Performance status, business.industry, CLINICAL-FEATURES, medicine.disease, Survival Analysis, digestive system diseases, ADVANCED HEPATITIS-C, ROC Curve, PERCUTANEOUS ETHANOL INJECTION, Percutaneous ethanol injection, business
Abstract

Alpha-fetoprotein is a tumor marker that has been used for surveillance and diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. The prognostic capability of this marker in patients with HCC has not been clearly defined. In this study our aim was to evaluate the prognostic usefulness of serum alpha-fetoprotein in patients with well-compensated cirrhosis, optimal performance status, and small HCC identified during periodic surveillance ultrasound who were treated with curative intent. Among the 3,027 patients included in the Italian Liver Cancer study group database, we selected 205 Child-Pugh class A and Eastern Cooperative Group Performance Status 0 patients with cirrhosis with a single HCC ≤3 cm of diameter diagnosed during surveillance who were treated with curative intent (hepatic resection, liver transplantation, percutaneous ethanol injection, radiofrequency thermal ablation). Patients were subdivided according to alpha-fetoprotein serum levels (i.e., normal ≤20 ng/mL; mildly elevated 21-200 ng/mL; markedly elevated >200 ng/mL). Patient survival, as assessed by the Kaplan-Meier method, was not significantly different among the three alpha-fetoprotein classes (P = 0.493). The same result was obtained in the subgroup of patients with a single HCC ≤2 cm (P = 0.714). An alpha-fetoprotein serum level of 100 ng/mL identified by receiver operating characteristic curve had inadequate accuracy (area under the curve = 0.536, 95% confidence interval = 0.465-0.606) to discriminate between survivors and deceased patients. Conclusion: Alpha-fetoprotein serum levels have no prognostic meaning in well-compensated cirrhosis patients with single, small HCC treated with curative intent. (HEPATOLOGY 2012)

Published
2012

15. Cost-effectiveness of semi-annual surveillance for hepatocellular carcinoma in cirrhotic patients of the Italian Liver Cancer population

Author

CUCCHETTI, ALESSANDRO, TREVISANI, FRANCO, CESCON, MATTEO, ERCOLANI, GIORGIO, ZOLI, MARCO, PINNA, ANTONIO DANIELE, GRAMENZI, ANNAGIULIA, Farinati F., Poggio P. D., Rapaccini G., Nolfo M. A., Benvegnù L., Borzio F., Giannini E. G., Caturelli E., Chiaramonte M., BERNARDI, MAURO, Buccione D., CARACENI, PAOLO, Domenicali M., Erroi V., Fatti G., Frigerio M., Santi V., Magalotti D., Balsamo C., DI MARCO, MARIACRISTINA, Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., Cazzagon N., Giacomin A., Pozzan C., Sergio A., Vanin V., Giampalma E., Golfieri R., Mosconi C., Renzulli M., Ghittoni G., Roselli P., Bodini G., Corbo M., Savarino V., DOMENICALI, MARCO, Cucchetti A., Trevisani F., Cescon M., Ercolani G., Farinati F., Poggio P.D., Rapaccini G., Nolfo M.A., Benvegnù L., Zoli M., Borzio F., Giannini E.G., Caturelli E., Chiaramonte M., Pinna A.D., Bernardi M., Buccione D., Caraceni P., Domenicali M., Erroi V., Fatti G., Frigerio M., Gramenzi A., Santi V., Magalotti D., Balsamo C., Di Marco M., Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., Cazzagon N., Giacomin A., Pozzan C., Sergio A., Vanin V., Giampalma E., Golfieri R., Mosconi C., Renzulli M., Ghittoni G., Roselli P., Bodini G., Corbo M., and Savarino V.

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Population, COST-EFFECTIVENESS ANALYSIS, Liver transplantation, Risk Factors, Internal medicine, SURVEILLANCE, medicine, Humans, HEPATOCELLULAR CARCINOMA, Intensive care medicine, education, Survival rate, CIRRHOSIS, Aged, Aged, 80 and over, education.field_of_study, Hepatology, Relative survival, business.industry, Incidence, Liver Neoplasms, Odds ratio, Middle Aged, Prognosis, medicine.disease, Markov Chains, Survival Rate, Italy, Population Surveillance, Female, business, Liver cancer, Incremental cost-effectiveness ratio
Abstract

BACKGROUND AND AIMS: It was recently shown that semi-annual surveillance for hepatocellular carcinoma (HCC) in cirrhotic patients provides a prognostic advantage over the annual program; however, its cost-effectiveness (CE) in the general cirrhotic population still needs to be defined. METHODS: A Markov model was built to compare CE of these two strategies, considering literature results and treatment modalities of 918 cirrhotic patients from the Italian Liver Cancer (ITA.LI.CA) database. RESULTS: Results from the Markov model suggest that, compared to annual surveillance, semi-annual surveillance leads to a gain in quality-adjusted life expectancy, in an unselected cirrhotic population, of 1.35 quality-adjusted life-months (QALMs) over 10 years since surveillance start in compensated patients, and of 0.73 QALMs in decompensated patients. Semi-annual surveillance was more cost-effective in compensated than in decompensated cirrhosis, with an incremental CE ratio (ICER) of 1997 and 3814€/QALM, respectively. In compensated cirrhosis, semi-annual surveillance was more cost-effective than the annual program when the annual HCC incidence was ≥3.2% and the relative survival gain after cancer diagnosis was ≥20% with respect to the annual program. In decompensated cirrhosis, semi-annual surveillance was cost-effective in patients amenable to liver transplantation. In both groups, CE of semi-annual surveillance improved with the increase of annual incidence and the survival benefit obtainable with HCC treatment. CONCLUSIONS: Both surveillance strategies for HCC in cirrhotic patients can be recommended, according to the individual risk profile for HCC occurrence and the expected survival gain obtainable after tumor diagnosis and therapy.

Published
2012

16. Treatments for hepatocellular carcinoma in elderly patients are as effective as in younger patients: a 20 year multicentre experience

Author

MIRICI CAPPA, FEDERICA, GRAMENZI, ANNAGIULIA, ZAMBRUNI, ANDREA, DI MICOLI, ANTONIO, FRIGERIO, MARTA, ZOLI, MARCO, BERNARDI, MAURO, TREVISANI, FRANCO, Santi V, Maraldi F, Di Nolfo MA, Del Poggio P, Benvegnù L, Rapaccini G, Farinati F, Borzio F, Giannini EG, Caturelli E, for the Italian Liver Cancer group, Mirici-Cappa F, Gramenzi A, Santi V, Zambruni A, Di Micoli A, Frigerio M, Maraldi F, Di Nolfo MA, Del Poggio P, Benvegnù L, Rapaccini G, Farinati F, Zoli M, Borzio F, Giannini EG, Caturelli E, Bernardi M, Trevisani F, and for the Italian Liver Cancer (ITA.LI.CA.) group.

Subjects
Male, medicine.medical_specialty, Percutaneous, Cirrhosis, Carcinoma, Hepatocellular, Population, Internal medicine, medicine, Hepatectomy, Humans, HEPATOCELLULAR CARCINOMA, Chemoembolization, Therapeutic, education, Aged, education.field_of_study, ELDERLY, business.industry, Liver Neoplasms, Gastroenterology, Age Factors, Cancer, CANCER STAGE, Retrospective cohort study, TREATMENT, Middle Aged, medicine.disease, Prognosis, Surgery, Treatment Outcome, Hepatocellular carcinoma, Propensity score matching, Catheter Ablation, SURVIVAL, Female, Liver function, business, Epidemiologic Methods
Abstract

Objectives The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is expected to increase. We compared the presenting features and outcome of HCC in elderly (≥70 years) and younger patients ( Design Multicentre retrospective cohort study and nested case–control study. Patients 614 elderly and 1104 younger patients from the ITA.LI.CA database, including 1834 HCC cases consecutively diagnosed from January 1987 to December 2004. Both groups were stratified according to treatment: hepatic resection, percutaneous procedures, transarterial chemoembolisation (TACE). Survival was assessed in the whole population and in each treatment subgroup. Age, sex, aetiology, cirrhosis, comorbidities and cancer stage (CLIP score) were tested as predictors of survival. In each subgroup, differences in patient survival were also assessed after adjustment and matching by propensity score. Results Ageing was associated with a higher prevalence of comorbidities, better liver function and CLIP score. Regardless of age, two-thirds of patients underwent radical treatments or TACE. Elderly patients underwent more ablative procedures and fewer resections or TACE sessions. The survival of elderly and younger patients was comparable in each treatment subset, and was predicted by CLIP score. This result was confirmed by the propensity analysis. Conclusions The overall applicability of radical or effective HCC treatments was unaffected by old age. However, treatment distribution differed, elderly individuals being more frequently treated with percutaneous procedures and less frequently with resection or TACE. Survival was unaffected by age and primarily predicted by cancer stage, assessed by the CLIP system, both in the overall population and in treatment subgroups.

Published
2010

17. Semiannual surveillance is superior to annual surveillance for the detection of early hepatocellular carcinoma and patient survival

Author

Santi, V, Del Poggio, P, Di Nolfo, MA, Benvegnù, L, Farinati, F, Giannini, EG, Borzio, F, Caturelli, E, Chiaramonte, M, Italian Liver Cancer Group, DOMENICALI, MARCO, TREVISANI, FRANCO, GRAMENZI, ANNAGIULIA, GRIGNASCHI, ALICE, MIRICI CAPPA, FEDERICA, ZOLI, MARCO, BERNARDI, MAURO, Santi, V, Trevisani, F, Gramenzi, A, Grignaschi, A, Mirici Cappa, F, Del Poggio, P, Di Nolfo, MA, Benvegnù, L, Farinati, F, Zoli, M, Giannini, EG, Borzio, F, Caturelli, E, Chiaramonte, M, Bernardi, M, and Italian Liver Cancer (ITA.LI.CA) Group.

Subjects
Liver Cirrhosis, Male, Cirrhosis, Cost effectiveness, medicine.medical_treatment, RADIOFREQUENCY THERMAL ABLATION, Gastroenterology, COST-EFFECTIVENESS, Liver disease, PERCUTANEOUS ETHANOL INJECTION, RADIOFREQUENCY THERMAL ABLATION, CIRRHOTIC-PATIENTS, COST-EFFECTIVENESS, EARLY-DIAGNOSIS, LIVER-DISEASE, RISK-FACTORS, EXPERIENCE, MANAGEMENT, RESECTION, CIRRHOSIS, Ultrasonography, Aged, 80 and over, Liver Neoplasms, CANCER STAGE, SURVEILLANCE INTERVAL, Middle Aged, Prognosis, Survival Rate, Italy, Liver, Population Surveillance, Hepatocellular carcinoma, Disease Progression, SURVIVAL, CIRRHOTIC-PATIENTS, Female, Adult, medicine.medical_specialty, RESECTION, Carcinoma, Hepatocellular, LIVER-DISEASE, Internal medicine, MANAGEMENT, medicine, Humans, Early Hepatocellular Carcinoma, HEPATOCELLULAR CARCINOMA, Aged, Hepatology, business.industry, Cancer, EARLY-DIAGNOSIS, medicine.disease, Confidence interval, RISK-FACTORS, EXPERIENCE, PERCUTANEOUS ETHANOL INJECTION, Percutaneous ethanol injection, business
Abstract

The current guidelines recommend the surveillance of cirrhotic patients for early diagnosis of hepatocellular carcinoma (HCC), based on liver ultrasonography repetition at either 6 or 12 month intervals, since there is no compelling evidence of superiority of the more stringent program. This study aimed at comparing cancer stage, treatment applicability, and survival between patients on semiannual or annual surveillance.We analyzed the clinical records of 649 HCC patients in Child-Pugh class A or B, observed in ITA.LI.CA centers. HCC was detected in 510 patients submitted to semiannual surveillance (Group 1) and in 139 submitted to annual surveillance (Group 2). In Group 1 the survival was presented as observed and corrected for the lead time.The cancer stage was less severe in Group 1 than in Group 2 (p0.001), with more single tiny (2 cm) and less advanced tumors. Treatment applicability was improved by the semiannual program (p=0.020). The median observed survival was 45 months (95% CI 40.0-50.0) in Group 1 and 30 months (95% CI 24.0-36.0) in Group 2 (p=0.001). The median corrected survival of Group 1 was 40.3 months (95% CI 34.9-45.7) (p=0.028 with respect to the observed survival of Group 2). Age, platelet count, alpha-fetoprotein, Child-Pugh class, cancer stage, and hepatocellular carcinoma treatment were independent prognostic factors.Semiannual surveillance increases the detection rate of very early hepatocellular carcinomas and reduces the number of advanced tumors as compared to the annual program. This translates into a greater applicability of effective treatments and into a better prognosis.

Published
2010

18. Long term follow-up and outcome of liver transplantation for alcoholic liver disease: a single center case-control study

Author

BISELLI, MAURIZIO, GRAMENZI, ANNAGIULIA, DEL GAUDIO, MASSIMO, RAVAIOLI, MATTEO, VITALE, GIOVANNI, GITTO, STEFANO, GRAZI, GIAN LUCA, PINNA, ANTONIO DANIELE, ANDREONE, PIETRO, BERNARDI, MAURO, Bologna Liver Transplantation Group, BIANCHI, FRANCESCO BIANCO, BOLONDI, LUIGI, CESCON, MATTEO, D'ERRICO, ANTONIETTA, ERCOLANI, GIORGIO, GRIGIONI, FRANCO, LENZI, MARCO, LODATO, FRANCESCA, MAZZELLA, GIUSEPPE, PISCAGLIA, FABIO, RODA, ENRICO, SAMA, CLAUDIA, TAME', MARIAROSA, Biselli M, Gramenzi A, Del Gaudio M, Ravaioli M, Vitale G, Gitto S, Grazi GL, Pinna AD, Andreone P, Bernardi M, and and Bologna Liver Transplantation Group.

Subjects
Adult, Graft Rejection, Male, Reoperation, medicine.medical_specialty, Alcoholic liver disease, Cirrhosis, medicine.medical_treatment, Alcoholic hepatitis, Liver transplantation, CHRONIC HEPATITIS C, LONG-TERM OUTCOME, Single Center, Gastroenterology, Postoperative Complications, Liver Cirrhosis, Alcoholic, Recurrence, Internal medicine, medicine, Humans, ALCOHOLIC LIVER CIRRHOSIS, LIVER TRANSPLANTATION, business.industry, Graft Survival, Case-control study, Odds ratio, Middle Aged, medicine.disease, Hepatitis C, Confidence interval, Survival Rate, Alcoholism, Treatment Outcome, surgical procedures, operative, Case-Control Studies, Multivariate Analysis, Female, business, Follow-Up Studies
Abstract

Background: Alcoholic liver cirrhosis (ALC) is a leading indication for orthotopic liver transplantation (OLT). Goals: To investigate the long-term outcome of OLT for ALC compared with patients transplanted for hepatitis C virus (HCV) infection. Study: From 1987 to 2001, 49 OLT were performed for ALC and 173 for HCV. From these contemporary groups we matched 1:2 ALC patients (cases) to 98 HCV (controls). The following variables were analyzed: survival, retransplantation, rejection, primary nonfunction, infections, de novo tumors, cardiovascular and neurologic complications, and alcoholic recurrence. Results: Actuarial survival rate at 9 years was comparable for cases and controls. Actuarial graft survival rate at 9 years was significantly higher in cases (78% vs. 60%; P = 0.026). The retransplantation rate was higher in controls (21 % vs. 4%; P = 0.007). Post-OLT complications were not significantly different. The alcoholic recidivism rate was 28% without influence on patients or graft survival, whereas relapse of HCV caused the majority of death in controls (30%; P = 0.042). At multivariate analysis retransplantation was the only predictor of patient survival (odds ratio: 4.35; 95% confidence interval: 2.16-8.74; P < 0.001), whereas HCV was associated with a 2-fold probability of graft failure (odds ratio: 1.97; 95% confidence interval: 1.02-3.81; P = 0.032). Conclusions: The long-term outcome of OLT for ALC is comparable to that for HCV, even if graft survival is significantly better among ALC. These data support ALC as an excellent indication for OLT.

Published
2010

19. Hepatocellular carcinoma in patients with cryptogenic cirrhosis

Author

Edoardo Giovanni Giannini, Elisa Marabotto, Vincenzo Savarino, Maria Anna di Nolfo, Paolo Del Poggio∥, Luisa Benvegnù, Fabio Farinati, Franco Borzio, Eugenio Caturelli, Maria Chiaramonte, Italian Liver Cancer Group [. . ., Cursaro C., Di Micoli A., Frigerio M., Cappa F. M., Santi V., Zambruni A., GRAZI, GIAN LUCA, Ravaioli M., Giampalma E., Di Marco M., Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., De Giorgio M., Gianni S., Rinaldi M., Roselli P., Ghittoni G., TREVISANI, FRANCO, ZOLI, MARCO, ANDREONE, PIETRO, BERNARDI, MAURO, CARACENI, PAOLO, DOMENICALI, MARCO, GRAMENZI, ANNAGIULIA, NARDO, BRUNO, GOLFIERI, RITA, Edoardo Giovanni Giannini, Elisa Marabotto, Vincenzo Savarino, Franco Trevisani, Maria Anna di Nolfo, Paolo Del Poggio∥, Luisa Benvegnù, Fabio Farinati, Marco Zoli, Franco Borzio, Eugenio Caturelli, Maria Chiaramonte, Italian Liver Cancer (ITALICA) Group [.., Andreone P., Bernardi M., Caraceni P., Cursaro C., Di Micoli A., Domenicali M., Gramenzi A., Frigerio M., Cappa F.M., Santi V., Zambruni A., Grazi G.L., Nardo B., Ravaioli M., Giampalma E., Golfieri R., Di Marco M., Vavassori E., Gilardoni L., Mattiello M., Alberti A., Gatta A., Gios M., De Giorgio M., Gianni S., Rinaldi M., Roselli P., Ghittoni G., and ]

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, HEPATOCELLULAR CARCINOMA, CRYPTOGENIC CIRRHOSIS, Hepatitis C virus, medicine.disease_cause, Gastroenterology, Internal medicine, medicine, Carcinoma, Humans, Transaminases, Aged, Hepatitis, Chronic, Hepatitis B virus, Hepatitis, Aged, 80 and over, Hepatology, business.industry, Platelet Count, Middle Aged, medicine.disease, digestive system diseases, Cryptogenic cirrhosis, Hepatocellular carcinoma, Female, Liver function, business, Liver cancer
Abstract

BACKGROUND & AIMS: Patients with cryptogenic cirrhosis (CC) can develop hepatocellular carcinoma (HCC), although the clinical characteristics of HCC in these patients have not been completely defined. We aimed to characterize the clinical features of patients diagnosed with HCC after CC during a 15-year period (1992-2006). METHODS: The clinical characteristics of 45 consecutive CC patients with HCC were analyzed, along with modality of diagnosis, tumor stage, treatment, survival, and causes of death. Data were compared with those of 426 consecutive patients with HCC and only hepatitis C virus (HCV) infection, diagnosed during the same period at the Italian Liver Cancer group centers. RESULTS: HCC patients with CC had similar impairments in liver function as patients with HCV infection (Child-Pugh class A: 53% vs 65%; P = .141). However, the HCC patients with CC had lower aminotransferase levels (P < .001) and higher platelet counts (P < .001). HCC was significantly less likely to be diagnosed during surveillance in CC patients (29% vs 64%; P < .0001). Patients with CC had a significantly greater prevalence of advanced HCC stage, according to Milano criteria (69% vs 41%; P < .0005), larger HCC size (4.9 vs 3.0 cm; P = .0001), lower amenability to any treatment (27% vs 42%; P = .036), and shorter survival times (P = .009, log-rank test) compared with HCV patients. Causes of death were similar in the 2 groups. CONCLUSIONS: Compared with HCV patients, HCC in CC patients often is diagnosed at an advanced stage, probably owing to lack of surveillance; this leads to limited treatment options and shorter survival times.

Published
2009

20. Surveillance for early diagnosis of hepatocellular carcinoma: is it effective in intermediate/advanced cirrhosis?

Author

V. Santi, TREVISANI, FRANCO, GRAMENZI, ANNAGIULIA, R. Casadio, A. M. Di Nolfo, P. Del Poggio, L. Benvegnù, G. Rapaccini, F. Farinati, ZOLI, MARCO, F. Borzio, E. G. Giannini, E. Caturelli, BERNARDI, MAURO, V. Santi, F. Trevisani, A. Gramenzi, R. Casadio, A.M. Di Nolfo, P. Del Poggio, L. Benvegnù, G. Rapaccini, F. Farinati, M. Zoli, F. Borzio, E.G. Giannini, E. Caturelli, M. Bernardi., Trevisani F, Santi V, Gramenzi A, Di Nolfo MA, Poggio PD, Benvegnù L, Rapaccini G, Farinati F, Zoli M, Borzio F, Giovanni Giannini E, Caturelli E, Bernardi M, and for the Italian Liver Cancer (ITA.LI.CA.) group.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, PROGNOSIS, Gastroenterology, Liver Function Tests, Internal medicine, SURVEILLANCE, Biomarkers, Tumor, Carcinoma, medicine, Humans, Prospective Studies, HEPATOCELLULAR CARCINOMA, Survival rate, CIRRHOSIS, Aged, Neoplasm Staging, Proportional Hazards Models, Ultrasonography, Hepatology, medicine.diagnostic_test, business.industry, Advanced cirrhosis, Liver Neoplasms, Cancer, Anatomical pathology, Middle Aged, medicine.disease, digestive system diseases, Survival Rate, EARLY DIAGNOSIS, Italy, Population Surveillance, Hepatocellular carcinoma, Female, alpha-Fetoproteins, Liver function tests, business
Abstract

Surveillance of cirrhotic patients for early diagnosis of hepatocellular carcinoma (HCC), based on ultrasonography and alpha-fetoprotein (AFP) measurement, is widely used. Its effectiveness depends on liver function, which affects the feasibility of treatments and cirrhosis-related mortality. We assessed whether patients with intermediate/advanced cirrhosis benefit from surveillance.We selected 468 Child-Pugh class B and 140 class C patients from the ITA.LI.CA database, including 1,834 HCC patients diagnosed from January 1987 to December 2004. HCC was detected in 252 patients during surveillance (semiannual 172, annual 80 patients; group 1) and in 356 patients outside surveillance (group 2). Survival of surveyed patients was corrected for the estimated lead time.Child-Pugh class B: cancer stage (P0.001) and treatment distribution (P0.001) were better in group 1 than in group 2. The median (95% CI) survivals were 17.1 (13.5-20.6) versus 12.0 (9.4-14.6) months and the survival rates at 1, 3, and 5 yr were 60.4%versus 49.2%, 26.1%versus 16.1%, and 10.7%versus 4.3%, respectively (P= 0.022). AFP, gross pathology, and treatment of HCC were independent prognostic factors. Child-Pugh class C: cancer stage (P= 0.001) and treatment distribution (P= 0.021) were better in group 1 than in group 2. Nonetheless, median survival did not differ: 7.1 (2.1-12.1) versus 6.0 (4.1-7.9) months (P= 0.740).These results suggest surveillance be offered to class B patients and maintained for class A patients who migrate to the subsequent class. Surveillance becomes pointless in class C patients probably because the poor liver function adversely affects the overall mortality and HCC treatments.

Published
2007

21. Surveillance for hepatocellular carcinoma in elderly Italian patients with cirrhosis: effects on cancer staging and patient survival

Author

TREVISANI, FRANCO, CANTARINI, MARIA CHIARA, MORSELLI LABATE, ANTONIO MARIA, DE NOTARIIS, STEFANIA, ZOLI, MARCO, BERNARDI, MAURO, CARACENI, PAOLO, NARDO, BRUNO, GOLFIERI, RITA, Rapaccini G., Farinati F., Del Poggio P., Di Nolfo M. A., Benvegnù L., Borzio F., P. Andreone, M. Biselli, M. Cantarini, C. Cursaro, M. Domenicali, GRAMENZI, ANNAGIULIA, S. Li Bassi, D. Magalotti, F. Mirici Cappa A. Zambruni, DI MARCO, MARIACRISTINA, E. Vavassori, L. Gilardoni, M. Mattiello, A. Alberti, A. Gatta, M. Gios, M. Covino, G. Gasbarrini, A. Baldan, D. Marino, A. Sergio, M. Molaro, M. Sala, GRAZI, GIAN LUCA, M. Ravaioli, C. Rossi, Italian Liver Cancer group, Trevisani F., Cantarini M.C., Morselli Labate A.M., De Notariis S., Rapaccini G., Farinati F., Del Poggio P., Di Nolfo M.A., Benvegnù L., Zoli M., Borzio F., Bernardi M., P. Andreone, M. Biselli, P. Caraceni, M. Cantarini, C. Cursaro, M. Domenicali, A. Gramenzi, S. Li Bassi, D. Magalotti, F. Mirici Cappa A. Zambruni, M. Di Marco, E. Vavassori, L. Gilardoni, M. Mattiello, A. Alberti, A. Gatta, M. Gio, M. Covino, G. Gasbarrini, A. Baldan, D. Marino, A. Sergio, M. Molaro, M. Sala, G.L. Grazi, B. Nardo, M. Ravaioli, C. Rossi, R. Golfieri, and Italian Liver Cancer (ITALICA) group

Subjects
Liver Cirrhosis, Male, PROGNOSIS, Cirrhosis, FEATURES, Gastroenterology, CHRONIC LIVER-DISEASE, INFECTION, CHRONIC LIVER-DISEASE, DIAGNOSIS, CHEMOEMBOLIZATION, EXPERIENCE, MANAGEMENT, PROGNOSIS, INFECTION, FEATURES, TRIALS, CHEMOEMBOLIZATION, CIRRHOSIS, Ultrasonography, Liver Neoplasms, Age Factors, humanities, Survival Rate, TRIALS, Liver, Hepatocellular carcinoma, SURVIVAL, Female, alpha-Fetoproteins, HEPATOCELLULAR CARCINOMA, ELDERLY, SURVEILLANCE, medicine.medical_specialty, Carcinoma, Hepatocellular, DIAGNOSIS, Internal medicine, MANAGEMENT, Carcinoma, medicine, Biomarkers, Tumor, Humans, Survival rate, Cancer staging, Aged, Retrospective Studies, Hepatology, business.industry, Retrospective cohort study, Patient survival, social sciences, medicine.disease, digestive system diseases, Multicenter study, EXPERIENCE, business
Abstract

Surveillance of cirrhotic individuals for early detection of HCC, based on ultrasonography (US) and alpha1-fetoprotein (AFP) determination, is a recommended practice currently applied also to elderly patients. However, several age-related factors may jeopardize the results of surveillance in these patients. Aim of the study was to evaluate the benefit of surveillance for HCC in elderly individuals.Multicenter retrospective study on 1,277 consecutive patients with HCC. The inclusion criteria were: underlying chronic liver disease, description of cancer stage, and modalities of its diagnosis. Among the 1,037 patients fulfilling these criteria, 363 agedor = 70 yr were considered.The tumor was detected during surveillance, based on US and AFP performed every 6-12 months, in 158 individuals (group 1), incidentally in 138 (group 2) and because of symptoms in 67 (group 3). Surveillance reduced the risk of dealing with an advanced cancer (odds ratio (95% Confidence Interval): 0.18 (0.09-0.37) vs group 3, and 0.29 (0.17-0.49) vs group 2). The frequency of effective treatments decreased from group 1 to group 3 (73%, 57%, and 31%, respectively). The main cause of death was HCC progression. The survival corrected for the lead time of group 1 (median: 24 months) was significantly better than the crude survival of group 3 (7 months; p= 0.003) and barely better than that of group 2 (21 months). The latter also showed a better prognosis with respect to group 3 (p= 0.018).Surveillance for HCC improves the survival of elderly cirrhotic patients by expanding the percentage of cancers amenable to effective treatments.

Published
2004

22. Acupuncture as an Integrated intervention for the control of symptoms of climacteric syndrome in patients affected by breast cancer: the AcCliMaT projects

Author

Lesi Grazia, Petrucci Chiara, Artioli Fabrizio, Pandolfi Paolo, Benedetti Benedetta, Colombi Cristina, Gramenzi Annagiulia, Ligabue Maria Bernadette, Cardini Francesco, Scaltriti Laura, Rondini Ermanno, Botti Alberto, and Razzini Giorgia

Subjects
medicine.medical_specialty, Breast cancer, Complementary and alternative medicine, business.industry, Intervention (counseling), Acupuncture, Physical therapy, medicine, Alternative medicine, In patient, Climacteric syndrome, business, medicine.disease
Published
2012
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24. Surveillance for hepatocellular carcinoma with a 3-months interval in 'extremely high-risk' patients does not further improve survival

Author

Filippo Pelizzaro, Giulia Peserico, Marco D'Elia, Nora Cazzagon, Francesco Paolo Russo, Alessandro Vitale, Edoardo G. Giannini, Manuela Piccinnu, Gian Ludovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Rodolfo Sacco, Giuseppe Cabibbo, Fabio Marra, Andrea Mega, Filomena Morisco, Antonio Gasbarrini, Gianluca Svegliati-Baroni, Francesco Giuseppe Foschi, Andrea Olivani, Alberto Masotto, Gerardo Nardone, Giovanni Raimondo, Francesco Azzaroli, Gianpaolo Vidili, Filippo Oliveri, Franco Trevisani, Fabio Farinati, Maurizio Biselli, Paolo Caraceni, Francesca Garuti, Annagiulia Gramenzi, Andrea Neri, Valentina Santi, Fabio Piscaglia, Francesco Tovoli, Alessandro Granito, Luca Muratori, Francesca Benevento, Elton Dajti, Giovanni Marasco, Federico Ravaioli, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Angela Imondi, Anna Sartori, Barbara Penzo, Elisa Pinto, Ester Marina Cela, Antonio Facciorusso, Valentina Cacciato, Edoardo Casagrande, Alessandro Moscatelli, Gaia Pellegatta, Nicoletta De Matthaeis, Gloria Allegrini, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Fabrizio Chegai, Fabio Coratella, Mariano Ortenzi, Gabriele Missale, Alessandro Inno, Fabiana Marchetti, Anita Busacca, Calogero Cammà, Vincenzo Di Martino, Giacomo Emanuele Maria Rizzo, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Vittoria Bevilacqua, Alberto Borghi, Andrea Casadei Gardini, Fabio Conti, Anna Chiara Dall'aglio, Giorgio Ercolani, Federica Mirici, Claudia Campani, Chiara Di Bonaventura, Stefano Gitto, Pietro Coccoli, Antonio Malerba, Maria Guarino, Maurizia Brunetto, Veronica Romagnoli, Pelizzaro, F., Peserico, G., D'Elia, M., Cazzagon, N., Russo, F. P., Vitale, A., Giannini, E. G., Piccinnu, M., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Sacco, R., Cabibbo, G., Marra, F., Mega, A., Morisco, F., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Olivani, A., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Farinati, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Santi, V., Piscaglia, F., Tovoli, F., Granito, A., Muratori, L., Benevento, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Imondi, A., Sartori, A., Penzo, B., Pinto, E., Cela, E. M., Facciorusso, A., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., De Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Missale, G., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Casadei Gardini, A., Conti, F., Dall'Aglio, A. C., Ercolani, G., Mirici, F., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Guarino, M., Brunetto, M., Romagnoli, V., Pelizzaro, Filippo, Peserico, Giulia, D'Elia, Marco, Cazzagon, Nora, Russo, Francesco Paolo, Vitale, Alessandro, Giannini, Edoardo G., Piccinnu, Manuela, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Trevisani, Franco, Farinati, Fabio, Biselli, Maurizio, Caraceni, Paolo, Garuti, Francesca, Gramenzi, Annagiulia, Neri, Andrea, Santi, Valentina, Piscaglia, Fabio, Tovoli, Francesco, Granito, Alessandro, Muratori, Luca, Benevento, Francesca, Dajti, Elton, Marasco, Giovanni, Ravaioli, Federico, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Imondi, Angela, Sartori, Anna, Penzo, Barbara, Pinto, Elisa, Cela, Ester Marina, Facciorusso, Antonio, Cacciato, Valentina, Casagrande, Edoardo, Moscatelli, Alessandro, Pellegatta, Gaia, De Matthaeis, Nicoletta, Allegrini, Gloria, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Missale, Gabriele, Inno, Alessandro, Marchetti, Fabiana, Busacca, Anita, Cammà, Calogero, Di Martino, Vincenzo, Rizzo, Giacomo Emanuele Maria, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Bevilacqua, Vittoria, Borghi, Alberto, Casadei Gardini, Andrea, Conti, Fabio, Dall'aglio, Anna Chiara, Ercolani, Giorgio, Mirici, Federica, Campani, Claudia, Di Bonaventura, Chiara, Gitto, Stefano, Coccoli, Pietro, Malerba, Antonio, Guarino, Maria, Brunetto, Maurizia, and Romagnoli, Veronica

Subjects
medicine.medical_specialty, Carcinoma, Hepatocellular, Survival, Hepatocellular carcinoma, Cancer stage, Surveillance interval, Internal medicine, medicine, Humans, Propensity Score, Survival analysis, High risk patients, Hepatology, business.industry, Liver Neoplasms, Settore MED/09 - MEDICINA INTERNA, Gastroenterology, Patient survival, medicine.disease, Survival Analysis, Propensity score matching, Survival Analysi, Liver cancer, business, Median survival, Human
Abstract

Background An enhanced surveillance schedule has been proposed for cirrhotics with viral etiology, who are considered at extremely high-risk of hepatocellular carcinoma (HCC). Aims We compared the 3- and 6-months surveillance interval, evaluating cancer stage at diagnosis and patient survival. Methods Data of 777 HBV and HCV cirrhotic patients with HCC diagnosed under a 3-months (n = 109, 3MS group) or a 6-months (n = 668, 6MS group) surveillance were retrieved from the Italian Liver Cancer database. Survival in the 3MS group was considered as observed and adjusted for lead-time bias, and survival analysis was repeated after a propensity score matching. Results The 3-months surveillance interval neither reduced the share of patients diagnosed outside the Milano criteria, nor increased their probability to receive curative treatments. The median survival of 6MS patients (55.0 months [45.9–64.0]) was not significantly different from the observed (47.0 months [35.0–58.9]; p = 0.43) and adjusted (44.9 months [33.4–56.4]; p = 0.30) survival of 3MS patients. A propensity score analysis confirmed the absence of a survival advantage for 3MS patients. Conclusions A tightening of surveillance schedule does not increase the diagnosis of early-stage tumors, the feasibility of curative treatments and the survival. Therefore, we should maintain the 6-months interval in the surveillance of viral cirrhotics.

Published
2022

25. Metabolic disorders across hepatocellular carcinoma in Italy

Author

Morisco, F., Guarino, M., Valvano, M. R., Auriemma, F., Farinati, F., Giannini, E. G., Ciccarese, F., Tovoli, F., Rapaccini, Gian Ludovico, Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cabibbo, G., Felder, M., Benvengu, L., Gasbarrini, Antonio, Svegliati Baroni, G., Foschi, F. G., Biasini, E., Masotto, A., Virdone, R., Marra, F., Caporaso, N., Trevisani, F., Sessa, A., Marafatto, F., Peserico, G., Pozzan, C., Brunacci, M., Moscatelli, A., Pellegatta, G., Savarino, V., Del Poggio, P., Olmi, S., De Matthaeis, Nicoletta, Balsamo, C., Vavassori, E., Roselli, P., Lauria, V., Pelecca, G., Mismas, V., Rossi, M., Attardo, S., Cavani, G., Mega, A., Rinninella, Emanuele, Ortolani, A., Bevilacqua, V., Chiara Dall'Aglio, A., Ercolani, G., Fiorini, Carlo Ettore, Casadei Gardini, A., Lanzi, Alessio, Mirici Cappa, F., Missale, G., Porro, E., Marchetti, F., Valerio, M., Affronti, A., Orlando, E., Rosa Barcellona, M., Aburas, S., Dragoni, G., Campani, C., Biselli, M., Bucci, L., Caraceni, P., Cucchetti, A., Domenicali, M., Garuti, F., Gramenzi, A., Magalotti, D., Serra, C., Granito, A., Negrini, G., Napoli, L., Piscaglia, F., Morisco, F., Guarino, M., Valvano, M. R., Auriemma, F., Farinati, F., Giannini, E. G., Ciccarese, F., Tovoli, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cabibbo, G., Felder, M., Benvengu, L., Gasbarrini, A., Svegliati Baroni, G., Foschi, F. G., Biasini, E., Masotto, A., Virdone, R., Marra, F., Caporaso, N., Trevisani, F., Sessa, A., Marafatto, F., Peserico, G., Pozzan, C., Brunacci, M., Moscatelli, A., Pellegatta, G., Savarino, V., Del Poggio, P., Olmi, S., de Matthaeis, N., Balsamo, C., Vavassori, E., Roselli, P., Lauria, V., Pelecca, G., Mismas, V., Rossi, M., Attardo, S., Cavani, G., Mega, A., Rinninella, E., Ortolani, A., Bevilacqua, V., Chiara Dall'Aglio, A., Ercolani, G., Fiorini, E., Casadei Gardini, A., Lanzi, A., Mirici Cappa, F., Missale, G., Porro, E., Marchetti, F., Valerio, M., Affronti, A., Orlando, E., Rosa Barcellona, M., Aburas, S., Dragoni, G., Campani, C., Biselli, M., Bucci, L., Caraceni, P., Cucchetti, A., Domenicali, M., Garuti, F., Gramenzi, A., Magalotti, D., Serra, C., Granito, A., Negrini, G., Napoli, L., Piscaglia, F., Morisco, Filomena, Guarino, Maria, Valvano, Maria R., Auriemma, Francesco, Farinati, Fabio, Giannini, Edoardo G., Ciccarese, Francesca, Tovoli, Francesco, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Felder, Martina, Benvengù, Luisa, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Foschi, Francesco G., Biasini, Elisabetta, Masotto, Alberto, Virdone, Roberto, Marra, Fabio, Caporaso, Nicola, Trevisani, Franco, Sessa, Anna, Marafatto, Filippo, Peserico, Giulia, Pozzan, Caterina, Brunacci, Matteo, Moscatelli, Alessandro, Pellegatta, Gaia, Savarino, Vincenzo, Del Poggio, Paolo, Olmi, Stefano, de Matthaeis, Nicoletta, Balsamo, Claudia, Vavassori, Elena, Roselli, Paola, Lauria, Valentina, Pelecca, Giorgio, Mismas, Valeria, Rossi, Margherita, Attardo, Simona, Cavani, Giulia, Mega, Andrea, Rinninella, Emanuele, Ortolani, Alessio, Bevilacqua, Vittoria, Chiara Dall'Aglio, Anna, Ercolani, Giorgio, Fiorini, Erica, Casadei Gardini, Andrea, Lanzi, Arianna, Mirici Cappa, Federica, Missale, Gabriele, Porro, Emanuela, Marchetti, Fabiana, Valerio, Matteo, Affronti, Andrea, Orlando, Emanuele, Rosa Barcellona, Maria, Aburas, Sami, Dragoni, Gabriele, Campani, Claudia, Biselli, Maurizio, Bucci, Laura, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Garuti, Francesca, Gramenzi, Annagiulia, Magalotti, Donatella, Serra, Carla, Granito, Alessandro, Negrini, Giulia, Napoli, Lucia, Piscaglia, Fabio, Valvano, Maria R, Giannini, Edoardo G, and Foschi, Francesco G

Subjects
Oncology, Male, obesity, Databases, Factual, Hepatocellular carcinoma, 0302 clinical medicine, Risk Factors, Prospective cohort study, diabetes, Metabolic disorder, Liver Neoplasms, Diabetes, hepatocellular carcinoma, Middle Aged, Metabolic syndrome, Portal vein thrombosis, Italy, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.medical_specialty, Carcinoma, Hepatocellular, Settore MED/12 - GASTROENTEROLOGIA, Obesity, metabolic syndrome, 03 medical and health sciences, Databases, Metabolic Diseases, Internal medicine, medicine, Diabetes Mellitus, Humans, Factual, Aged, Neoplasm Staging, Retrospective Studies, Hepatology, business.industry, Carcinoma, Hepatocellular, medicine.disease, Survival Analysis, BCLC Stage, Multivariate Analysis, diabete, Liver function, business
Abstract

Background: Metabolic disorders are well-known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its aetiology. Methods: We analysed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analysed: BMI, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0-1, 2 and 3-5 metabolic features. Results: As compared with patients with 0-1 metabolic features, patients with 3-5 features showed lower percentage of HCC diagnosis on surveillance (P=.021), larger tumours (P=.038), better liver function (higher percentage of Child-Pugh class A [P=.007] and MELD&nbsp

Published
2018

26. Trans-arterial radioembolization for intermediate-advanced hepatocellular carcinoma: a budget impact analysis

Author

Vincenzo Mazzaferro, Rodolfo Sacco, Silvia Sommariva, Carla Rognoni, Irene Bargellini, Rita Golfieri, Antonio Facciorusso, Cristina Mosconi, Oriana Ciani, Sherrie Bhoori, Franco Trevisani, Rosanna Tarricone, Francesca Romana Ponziani, Annagiulia Gramenzi, Roberto Cioni, Rognoni, Carla, Ciani, Oriana, Sommariva, Silvia, Bargellini, Irene, Bhoori, Sherrie, Cioni, Roberto, Facciorusso, Antonio, Golfieri, Rita, Gramenzi, Annagiulia, Mazzaferro, Vincenzo, Mosconi, Cristina, Ponziani, Francesca, Sacco, Rodolfo, Trevisani, Franco, and Tarricone, Rosanna

Subjects
Sorafenib, Oncology, Cancer Research, medicine.medical_specialty, Carcinoma, Hepatocellular, Tare weight, Cost, Context (language use), lcsh:RC254-282, Budget impact analysi, 03 medical and health sciences, 0302 clinical medicine, Genetic, TRANS-ARTERIAL RADIO-EMBOLIZATION, Surgical oncology, Internal medicine, Epidemiology, Genetics, medicine, Humans, HEPATOCELLULAR CARCINOMA, business.industry, Liver Neoplasms, BUDGET IMPACT ANALYSIS, Health Care Costs, Budget impact, HEPATOCELLULAR CARCINOMA, TRANS-ARTERIAL RADIO-EMBOLIZATION, SORAFENIB, BUDGET IMPACT ANALYSIS, COSTS, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Embolization, Therapeutic, Markov Chains, digestive system diseases, SORAFENIB, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Health Resources, 030211 gastroenterology & hepatology, Liver function, business, COSTS, Research Article, medicine.drug
Abstract

Background Trans-arterial radio-embolization (TARE) is an emerging treatment for the management of hepatocellular carcinoma (HCC). TARE may compete with systemic chemotherapy, sorafenib, in intermediate stage patients with prior chemoembolization failure or advanced patients with tumoral macrovascular invasion with no extra-hepatic spread and good liver function. We performed a budget impact analysis (BIA) evaluating the expected changes in the expenditure for the Italian Healthcare Service within scenarios of increased utilization of TARE in place of sorafenib over the next five years. Methods Starting from patient level data from three oncology centres in Italy, a Markov model was developed to project on a lifetime horizon survivals and costs associated to matched cohorts of intermediate-advanced HCC patients treated with TARE or sorafenib. The initial model has been integrated with epidemiological data to perform a BIA comparing the current scenario with 20 and 80% utilization rates for TARE and sorafenib, respectively, with increasing utilization rates of TARE of 30, 40 and 50% over the next 1, 3 and 5 years. Results Compared to the current scenario, progressively increasing utilization rates of TARE over sorafenib in the next 5 years is expected to save globally about 7 million Euros. Conclusions Radioembolization can be considered a valuable treatment option for patients with intermediate-advanced HCC. These findings enrich the evidence about the economic sustainability of TARE in comparison to standard systemic chemotherapy within the context of a national healthcare service. Electronic supplementary material The online version of this article (10.1186/s12885-018-4636-7) contains supplementary material, which is available to authorized users.

Published
2018

27. Biomarkers for the early diagnosis of bacterial infection and the surveillance of hepatocellular carcinoma in cirrhosis

Author

Annagiulia Gramenzi, Maurizio Biselli, Marco Dall'Agata, Fabio Conti, Conti, Fabio, Dall'Agata, Marco, Gramenzi, Annagiulia, and Biselli, Maurizio

Subjects
Liver Cirrhosis, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Clinical Biochemistry, Combined use, Early detection, liver, Systemic inflammation, Gastroenterology, Procalcitonin, Sepsis, Internal medicine, Drug Discovery, Humans, Medicine, business.industry, Liver Neoplasms, Biochemistry (medical), hepatocellular carcinoma, Bacterial Infections, medicine.disease, infection, digestive system diseases, Early Diagnosis, Hepatocellular carcinoma, surveillance, biomarker, medicine.symptom, business, Biomarkers, cirrhosi
Abstract

The early detection of bacterial infections and hepatocellular carcinoma (HCC) could ameliorate the prognosis of cirrhosis. C-reactive protein and procalcitonin are under investigation in the setting of cirrhosis as markers of sepsis. In the attempt to discriminate bacterial infection from systemic inflammation, the role of novel biomarkers such as lypopolysaccharide binding-protein, mid-regional fragment of pro-adrenomedullin and delta neutrophil index are currently in development. Concerning HCC, many studies attempted to evaluate biomarkers in the hope of ameliorating the accuracy of the surveillance based on ultrasound. The use of α-fetoprotein (AFP) has been extensively investigated, as well as other biomarkers expressed in the serum of HCC patients like lens culinaris agglutinin-reactive fraction of AFP, des-γ-carboxy prothrombin, glypican-3, α-l-fucosidase and their combined use.

Published
2015
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28. Curative therapies are superior to standard of care (transarterial chemoembolization) for intermediate stage hepatocellular carcinoma

Author

Pecorelli A, Lenzi B, Gramenzi A, Garuti F, Farinati F, Giannini EG, Ciccarese F, Piscaglia F, Rapaccini GL, Di Marco M, Caturelli E, Zoli M, Borzio F, Sacco R, Cabibbo G, Felder M, Morisco F, Gasbarrini A, Baroni GS, Foschi FG, Biasini E, Masotto A, Virdone R, Bernardi M, Trevisani F, Bolondi L, Biselli M, Bucci L, Caraceni P, Cucchetti A, Domenicali M, Venerandi L, Giacomin A, Maddalo G, Pozzan C, Vani V, Poggio PD, Olmi S, Balsamo C, Vavassori E, Benvegnù L, Cappelli A, Golfieri R, Mosconi C, Renzulli M, Bosco G, Roselli P, Dell'Isola S, Ialungo AM, Bruzzone L, Picciotto A, Marenco S, Risso D, Sammito G, Savarino V, Cammà C, Maida M, Costantino A, Barcellona MR, Affronti A, Mega A, Rinninella E, Mismas V, Cappa FM, Dall'Aglio AC, Feletti V, Lanzi A, Neri E, Stefanini GF, Tamberi S, Missale G, Porro E, Guarino M, Gemini S, Schiadà L, for the Italian LiverCancer (ITA. LI. CA) group, Donatella Magalotti, Carla Serra, Pecorelli A, Lenzi B, Gramenzi A, Garuti F, Farinati F, Giannini EG, Ciccarese F, Piscaglia F, Rapaccini GL, Di Marco M, Caturelli E, Zoli M, Borzio F, Sacco R, Cabibbo G, Felder M, Morisco F, Gasbarrini A, Baroni GS, Foschi FG, Biasini E, Masotto A, Virdone R, Bernardi M, Trevisani F, Bolondi L, Biselli M, Bucci L, Caraceni P, Cucchetti A, Domenicali M, Magalotti D, Serra C, Venerandi L, Giacomin A, Maddalo G, Pozzan C, Vani V, Poggio PD, Olmi S, Balsamo C, Vavassori E, Benvegnù L, Cappelli A, Golfieri R, Mosconi C, Renzulli M, Bosco G, Roselli P, Dell'Isola S, Ialungo AM, Bruzzone L, Picciotto A, Marenco S, Risso D, Sammito G, Savarino V, Cammà C, Maida M, Costantino A, Barcellona MR, Affronti A, Mega A, Rinninella E, Mismas V, Cappa FM, Dall'Aglio AC, Feletti V, Lanzi A, Neri E, Stefanini GF, Tamberi S, Missale G, Porro E, Guarino M, Gemini S, Schiadà L, Pecorelli, A., Lenzi, B., Gramenzi, A., Garuti, F., Farinati, F., Giannini, E. G., Ciccarese, F., Piscaglia, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Cabibbo, G., Felder, M., Morisco, F., Gasbarrini, A., Baroni, G. S., Foschi, F. G., Biasini, E., Masotto, A., Virdone, R., Bernardi, M., Trevisani, F., Bolondi, L., Biselli, M., Bucci, L., Caraceni, P., Cucchetti, A., Domenicali, M., Magalotti, D., Serra, C., Venerandi, L., Giacomin, A., Maddalo, G., Pozzan, C., Vani, V., Poggio, P. D., Olmi, S., Balsamo, C., Vavassori, E., Benvegnu, L., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Bosco, G., Roselli, P., Dell'Isola, S., Ialungo, A. M., Bruzzone, L., Picciotto, A., Marenco, S., Risso, D., Sammito, G., Savarino, V., Camma, C., Maida, M., Costantino, A., Barcellona, M. R., Affronti, A., Mega, A., Rinninella, E., Mismas, V., Cappa, F. M., Dall'Aglio, A. C., Feletti, V., Lanzi, A., Neri, E., Stefanini, G. F., Tamberi, S., Missale, G., Porro, E., Guarino, M., Gemini, S., Schiada, L., Pecorelli, Anna, Lenzi, Barbara, Gramenzi, Annagiulia, Garuti, Francesca, Farinati, Fabio, Giannini, Edoardo G, Ciccarese, Francesca, Piscaglia, Fabio, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Felder, Martina, Morisco, Filomena, Gasbarrini, Antonio, Baroni, Gianluca Svegliati, Foschi, Francesco G, Biasini, Elisabetta, Masotto, Alberto, Virdone, Roberto, Bernardi, Mauro, and Trevisani, Franco

Subjects
Sorafenib, Male, Niacinamide, medicine.medical_specialty, Standard of care, Carcinoma, Hepatocellular, Antineoplastic Agents, Gastroenterology, Intermediate stage, 03 medical and health sciences, 0302 clinical medicine, HCC, BCLC-B, Treatment, Hepatology, Internal medicine, medicine, Humans, Chemoembolization, Therapeutic, Propensity Score, Aged, Neoplasm Staging, Retrospective Studies, intermediate stage, treatment, business.industry, Patient Selection, Phenylurea Compounds, Liver Neoplasms, Settore MED/09 - MEDICINA INTERNA, Standard of Care, Middle Aged, medicine.disease, Survival Analysis, Treatment Outcome, Italy, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Propensity score matching, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, Liver function, Liver cancer, business, medicine.drug
Abstract

Background and aims the Barcelona Clinic Liver Cancer intermediate stage (BCLC-B) of hepatocellular carcinoma (HCC) includes extremely heterogeneous patients in terms of tumor burden and liver function. Transarterial-chemoembolization (TACE) is the first-line treatment for these patients although it may be risky/useless for someone, while others could undergo curative treatments. This study assesses the treatment type performed in a large cohort of BCLC-B patients and its outcome. Methods retrospective analysis of 485 consecutive BCLC-B patients from the ITA.LI.CA database diagnosed with naive HCC after 1999. Patients were stratified by treatment. Results 29 patients (6%) were lost to follow-up before receiving treatment. Treatment distribution was: TACE (233, 51.1%), curative treatments (145 patients, 31.8%), sorafenib (18, 3.9%), other (39, 8.5%), best supportive care (BSC) (21, 4.6%). Median survival (95% CI) was 45 months (37.4-52.7) for curative treatments, 30 (24.7-35.3) for TACE, 14 (10.5-17.5) for sorafenib, 14 (5.2-22.7) for other treatments and 10 (6.0-14.2) for BSC (p

Published
2017

29. Yttrium-90 radioembolization for unresectable/recurrent intrahepatic cholangiocarcinoma: a survival, efficacy and safety study

Author

Alberta Cappelli, Rita Golfieri, Annagiulia Gramenzi, Cinzia Pettinato, Salvatore Ascanio, Fabio Monari, Giovanni Brandi, Cristina Mosconi, Matteo Renzulli, Franco Trevisani, Alessandro Cucchetti, Mosconi, Cristina, Gramenzi, Annagiulia, Ascanio, Salvatore, Cappelli, Alberta, Renzulli, Matteo, Pettinato, Cinzia, Brandi, Giovanni, Monari, Fabio, Cucchetti, Alessandro, Trevisani, Franco, and Golfieri, Rita

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Cancer Research, Tare weight, 90Y-TARE, Malignancy, Gastroenterology, survival, 030218 nuclear medicine & medical imaging, Cholangiocarcinoma, 03 medical and health sciences, yttrium-90 radioembolization, 0302 clinical medicine, intrahepatic cholangiocarcinoma, Internal medicine, medicine, Humans, Yttrium Radioisotopes, Lung cancer, Intrahepatic Cholangiocarcinoma, Survival analysis, Aged, Cervical cancer, Aged, 80 and over, radiological tumour response, business.industry, Recurrent Intrahepatic Cholangiocarcinoma, Middle Aged, medicine.disease, Embolization, Therapeutic, Survival Analysis, adverse events, Bile Duct Neoplasms, 030220 oncology & carcinogenesis, Clinical Study, Female, Neoplasm Recurrence, Local, Liver cancer, business
Abstract

Background:Intrahepatic cholangiocarcinoma (ICC) is a rapidly progressing malignancy; only a minority of the tumours can be resected and the palliative regimens have shown limited success. The aim of this study was to assess overall survival (OS), tumour response and the safety of radioembolization with yttrium-90 (90Y-TARE) in patients with unresectable/recurrent ICC.Methods:Survival was calculated from the date of the 90Y-TARE procedure. Target and overall Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST) and European Association for the Study of the Liver (EASL)—measuring delayed-phase contrast enhancement—treatment responses were assessed at 3 months.Results:The overall median survival was 17.9 months (95% CI: 14.3–21.4 months). Significantly longer survival was obtained in naive patients as compared with patients in whom TARE was preceded by other treatments, including surgery (52 vs 16 months, P=0.009). Significantly prolonged OS was recorded for patients with a response based on mRECIST and the EASL criteria while RECIST responses were not found to be associated with survival. Treatment was well-tolerated, and no mortality was reported within 30 days.Conclusions:In unresectable ICC, 90Y-TARE is safe and offers a survival benefit in naive patients, as well as in responders.British Journal of Cancer (2016) advance online publication 23 June 2016; doi:10.1038/bjc.2016.191 www.bjcancer.com.

Published
2016

30. Reply to: 'Sorafenib or (90) Y loaded resin microsphere radioembolization for locally-advanced hepatocellular carcinoma, what should we trust?'

Author

Rita Golfieri, Franco Trevisani, Annagiulia Gramenzi, Cinzia Pettinato, Cristina Mosconi, Alberta Cappelli, Gramenzi, Annagiulia, Pettinato, Cinzia, Cappelli, Alberta, Mosconi, Cristina, Golfieri, Rita, and Trevisani, Franco

Subjects
Male, Niacinamide, Sorafenib, Carcinoma, Hepatocellular, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Locally advanced, sorafenib, radioembolization, locally-advanced hepatocellular caricnoma, Antineoplastic Agents, medicine.disease, Embolization, Therapeutic, Resin microsphere, Hepatocellular carcinoma, medicine, Cancer research, Humans, Female, Yttrium Radioisotopes, business, medicine.drug
Published
2015

31. A new prognostic model to predict dropout from the waiting list in cirrhotic candidates for liver transplantation with MELD score <18

Author

Maurizio Biselli, Roberto Montalti, Martina Gambato, Umberto Cillo, Marco Dall’Agata, Pietro Andreone, Patrizia Burra, Matteo Ravaioli, Caterina Liberati, Annagiulia Gramenzi, Lucia Brodosi, Mauro Bernardi, Giorgio Enrico Gerunda, Antonio Daniele Pinna, Stefano Gitto, Biselli, Maurizio, Dall'Agata, Marco, Gramenzi, Annagiulia, Gitto, Stefano, Liberati, Caterina, Brodosi, Lucia, Ravaioli, Matteo, Gambato, Martina, Montalti, Roberto, Pinna, Antonio D, Burra, Patrizia, Gerunda, Giorgio E, Cillo, Umberto, Andreone, Pietro, Bernardi, Mauro, Biselli M, Dall’Agata M, Gramenzi A, Gitto S, Liberati C, Brodosi L, Ravaioli M, Gambato M, Montalti R, Pinna AD, Burra P, Gerunda GE, Cillo U, Andreone P, Bernardi M., Biselli, M, Dall'Agata, M, Gramenzi, A, Gitto, S, Liberati, C, Brodosi, L, Ravaioli, M, Gambato, M, Montalti, R, Pinna, A, Burra, P, Gerunda, G, Cillo, U, Andreone, P, and Bernardi, M

Subjects
Liver Cirrhosis, Multivariate analysis, medicine.medical_treatment, Predictive Value of Test, Liver transplantation, Severity of Illness Index, survival analysis, Cohort Studies, Liver disease, Ascites, Dropout (neural networks), Competing risk, Organ allocation, Prognosis, Scoring system, Survival analysis, Wait list, liver transplantation, COMPETING RISKS, Waiting List, SECS-S/01 - STATISTICA, survival analysi, Ascite, Regression Analysis, medicine.symptom, Human, Glomerular Filtration Rate, medicine.medical_specialty, Prognostic variable, organ allocation, Waiting Lists, Prognosi, Liver Cirrhosi, Renal function, competing risk, Risk Assessment, Regression Analysi, End Stage Liver Disease, Predictive Value of Tests, Internal medicine, prognosis, scoring system, wait list, medicine, Humans, MED/01 - STATISTICA MEDICA, Serum Albumin, Hepatology, business.industry, Sodium, Bilirubin, Models, Theoretical, medicine.disease, Confidence interval, Surgery, MED/09 - MEDICINA INTERNA, Cohort Studie, business
Abstract

Background & Aims The model for end-stage liver disease (MELD) is used for organ allocation in liver transplantation (LT), but its prognostic performance is less accurate in patients with low score. We assess the outcome of patients with MELD 15.9. Conclusions In patients with low MELD (

Published
2015

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