112 results on '"Masotto, Alberto"'
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2. Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs
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Biselli, Maurizio, Caraceni, Paolo, Gramenzi, Annagiulia, Benevento, Francesca, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Tovoli, Francesco, Allegrini, Gloria, Cammà, Calogero, Cabibbo, Giuseppe, Giacchetto, Carmelo Marco, Giuffrida, Paolo, Grassini, Maria Vittoria, Grova, Mauro, Rancatore, Gabriele, Stornello, Caterina, Adotti, Valentina, Cavoli, Tancredi Li, Marra, Fabio, Rosi, Martina, Bevilacqua, Vittoria, Borghi, Alberto, Napoli, Lucia, Conti, Fabio, Frassineti, G.L., Migliano, Maria Teresa, de Matthaeis, Nicoletta, Ponziani, Francesca Romana, Missale, Gabriele, Olivani, Andrea, Capasso, Mario, Cossiga, Valentina, Guarino, Maria, Marina Cela, Ester, Facciorusso, Antonio, Graziosi, Camilla, Lauria, Valentina, Pelecca, Giorgio, Schirripa, Marta, Chegai, Fabrizio, Raso, Armando, Bozzi, Alessio, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Dajti, Elton, Ravaioli, Federico, Plaz Torres, Maria Corina, Pieri, Giulia, Oliveri, Filippo, Ricco, Gabriele, Romagnoli, Veronica, Inno, Alessandro, Marchetti, Fabiana, Coccoli, Pietro, Malerba, Antonio, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Reggidori, Nicola, Bucci, Laura, Santi, Valentina, Stefanini, Benedetta, Lani, Lorenzo, Rampoldi, Davide, Ghittoni, Giorgia, Farinati, Fabio, Masotto, Alberto, Stefanini, Bernardo, Mega, Andrea, Biasini, Elisabetta, Foschi, Francesco Giuseppe, Svegliati-Baroni, Gianluca, Sangiovanni, Angelo, Campani, Claudia, Raimondo, Giovanni, Vidili, Gianpaolo, Gasbarrini, Antonio, Celsa, Ciro, Di Marco, Mariella, Giannini, Edoardo G., Sacco, Rodolfo, Brunetto, Maurizia Rossana, Azzaroli, Francesco, Magalotti, Donatella, Morisco, Filomena, Rapaccini, Gian Ludovico, Nardone, Gerardo, Vitale, Alessandro, and Trevisani, Franco
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- 2023
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3. Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma
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Biselli, Maurizio, Caraceni, Paolo, Gramenzi, Annagiulia, Benevento, Francesca, Granito, Alessandro, Muratori, Luca, Piscaglia, Fabio, Bertellini, Federica, Farinati, Fabio, Palano, Giorgio, Pelizzaro, Filippo, Penzo, Barbara, Pinto, Elisa, Allegrini, Gloria, Cammà, Calogero, Celsa, Ciro, Giuffrida, Paolo, Stornello, Caterina, Grova, Mauro, Giacchetto, Carmelo Marco, Rancatore, Gabriele, Grassini, Maria Vittoria, Adotti, Valentina, Gitto, Stefano, Marra, Fabio, Rosi, Martina, Bevilacqua, Vittoria, Borghi, Alberto, Gardini, Andrea Casadei, Conti, Fabio, Napoli, Lucia, Domenicali, Marco, Migliano, Maria Teresa, de Matthaeis, Nicoletta, Ponziani, Francesca Romana, Olivani, Andrea, Missale, Gabriele, Cossiga, Valentina, Capasso, Mario, Morisco, Filomena, Cela, Ester Marina, Facciorusso, Antonio, Lauria, Valentina, Ghittoni, Giorgia, Pelecca, Giorgio, Chegai, Fabrizio, Coratella, Fabio, Ortenzi, Mariano, Dell'Isola, Serena, Franzè, Maria Stella, Saitta, Carlo, Sauchella, Assunta, Dajti, Elton, Ravaioli, Federico, Oliveri, Filippo, Ricco, Gabriele, Romagnoli, Veronica, Inno, Alessandro, Marchetti, Fabiana, Coccoli, Pietro, Malerba, Antonio, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Giannini, Edoardo G., Pieri, Giulia, Labanca, Sara, Plaz Torres, Maria Corina, Gasbarrini, Antonio, Biasini, Elisabetta, Campani, Claudia, Cazzagon, Nora, Foschi, Francesco Giuseppe, Mega, Andrea, Masotto, Alberto, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Sacco, Rodolfo, Caturelli, Eugenio, Guarino, Maria, Tovoli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Svegliati-Baroni, Gianluca, Magalotti, Donatella, Azzaroli, Francesco, Cabibbo, Giuseppe, Di Marco, Maria, Sangiovanni, Angelo, and Trevisani, Franco
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- 2022
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4. Comparison of prognostic models in advanced hepatocellular carcinoma patients undergoing Sorafenib: A multicenter study.
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Marasco, Giovanni, Colecchia, Antonio, Bacchi Reggiani, Maria Letizia, Celsa, Ciro, Farinati, Fabio, Giannini, Edoardo Giovanni, Benevento, Francesca, Rapaccini, Gian Ludovico, Caturelli, Eugenio, Di Marco, Mariella, Biasini, Elisabetta, Marra, Fabio, Morisco, Filomena, Foschi, Francesco Giuseppe, Zoli, Marco, Gasbarrini, Antonio, Baroni, Gianluca Svegliati, Masotto, Alberto, Sacco, Rodolfo, Raimondo, Giovanni, Azzaroli, Francesco, Mega, Andrea, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Dajti, Elton, Ravaioli, Federico, Avanzato, Francesca, Festi, Davide, and Trevisani, Franco
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- 2021
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5. Liver Resection vs Nonsurgical Treatments for Patients With Early Multinodular Hepatocellular Carcinoma
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Vitale, Alessandro, Romano, Pierluigi, Cillo, Umberto, Lauterio, Andrea, Sangiovanni, Angelo, Cabibbo, Giuseppe, Missale, Gabriele, Marseglia, Mariarosaria, Trevisani, Franco, Foschi, Francesco Giuseppe, Cipriani, Federica, Famularo, Simone, Marra, Fabio, Saitta, Carlo, Serenari, Matteo, Vidili, Gianpaolo, Morisco, Filomena, Caturelli, Eugenio, Mega, Andrea, Pelizzaro, Filippo, Nicolini, Daniele, Ardito, Francesco, Garancini, Mattia, Masotto, Alberto, Baroni, Gianluca Svegliati, Azzaroli, Francesco, Giannini, Edoardo, Perri, Pasquale, Scarinci, Andrea, Fontana, Andrea Pierluigi, Brunetto, Maurizia Rossana, Iaria, Maurizio, Di Marco, Maria, Nardone, Gerardo, Dominioni, Tommaso, Lai, Quirino, Ferrari, Cecilia, Rapaccini, Gian Ludovico, Rodolfo, Sacco, Romano, Maurizio, Conci, Simone, Zoli, Marco, Conticchio, Maria, Zanello, Matteo, Zimmitti, Giuseppe, Fumagalli, Luca, Troci, Albert, Germani, Paola, Gasbarrini, Antonio, La Barba, Giuliano, De Angelis, Michela, Patauner, Stefan, Molfino, Sarah, Zago, Mauro, Pinotti, Enrico, Frigo, Anna Chiara, Baiocchi, Gian Luca, Frena, Antonio, Boccia, Luigi, Ercolani, Giorgio, Tarchi, Paola, Crespi, Michele, Chiarelli, Marco, Abu Hilal, Moh’d, Cescon, Matteo, Memeo, Riccardo, Ruzzenente, Andrea, Zanus, Giacomo, Griseri, Guido, Rossi, Massimo, Maestri, Marcello, Della Valle, Raffaele, Ferrero, Alessandro, Grazi, Gian Luca, Romano, Fabrizio, Giuliante, Felice, Vivarelli, Marco, Jovine, Elio, Torzilli, Guido, Aldrighetti, Luca, and De Carlis, Luciano
- Abstract
IMPORTANCE: The 2022 Barcelona Clinic Liver Cancer algorithm currently discourages liver resection (LR) for patients with multinodular hepatocellular carcinoma (HCC) presenting with 2 or 3 nodules that are each 3 cm or smaller. OBJECTIVE: To compare the efficacy of liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE) in patients with multinodular HCC. DESIGN, SETTING, AND PARTICIPANTS: This cohort study is a retrospective analysis conducted using data from the HE.RC.O.LE.S register (n = 5331) for LR patients and the ITA.LI.CA database (n = 7056) for PRFA and TACE patients. A matching-adjusted indirect comparison (MAIC) method was applied to balance data and potential confounding factors between the 3 groups. Included were patients from multiple centers from 2008 to 2020; data were analyzed from January to December 2023. INTERVENTIONS: LR, PRFA, or TACE. MAIN OUTCOMES AND MEASURES: Survival rates at 1, 3, and 5 years were calculated. Cox MAIC-weighted multivariable analysis and competing risk analysis were used to assess outcomes. RESULTS: A total of 720 patients with early multinodular HCC were included, 543 males (75.4%), 177 females (24.6%), and 350 individuals older than 70 years (48.6%). There were 296 patients in the LR group, 240 who underwent PRFA, and 184 who underwent TACE. After MAIC, LR exhibited 1-, 3-, and 5-year survival rates of 89.11%, 70.98%, and 56.44%, respectively. PRFA showed rates of 94.01%, 65.20%, and 39.93%, while TACE displayed rates of 90.88%, 48.95%, and 29.24%. Multivariable Cox survival analysis in the weighted population showed a survival benefit over alternative treatments (PRFA vs LR: hazard ratio [HR], 1.41; 95% CI, 1.07-1.86; P = .01; TACE vs LR: HR, 1.86; 95% CI, 1.29-2.68; P = .001). Competing risk analysis confirmed a lower risk of cancer-related death in LR compared with PRFA and TACE. CONCLUSIONS AND RELEVANCE: For patients with early multinodular HCC who are ineligible for transplant, LR should be prioritized as the primary therapeutic option, followed by PRFA and TACE when LR is not feasible. These findings provide valuable insights for clinical decision-making in this patient population.
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- 2024
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6. Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs
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Reggidori, Nicola, primary, Bucci, Laura, additional, Santi, Valentina, additional, Stefanini, Benedetta, additional, Lani, Lorenzo, additional, Rampoldi, Davide, additional, Ghittoni, Giorgia, additional, Farinati, Fabio, additional, Masotto, Alberto, additional, Stefanini, Bernardo, additional, Mega, Andrea, additional, Biasini, Elisabetta, additional, Foschi, Francesco Giuseppe, additional, Svegliati-Baroni, Gianluca, additional, Sangiovanni, Angelo, additional, Campani, Claudia, additional, Raimondo, Giovanni, additional, Vidili, Gianpaolo, additional, Gasbarrini, Antonio, additional, Celsa, Ciro, additional, Di Marco, Mariella, additional, Giannini, Edoardo G., additional, Sacco, Rodolfo, additional, Brunetto, Maurizia Rossana, additional, Azzaroli, Francesco, additional, Magalotti, Donatella, additional, Morisco, Filomena, additional, Rapaccini, Gian Ludovico, additional, Nardone, Gerardo, additional, Vitale, Alessandro, additional, Trevisani, Franco, additional, Biselli, Maurizio, additional, Caraceni, Paolo, additional, Gramenzi, Annagiulia, additional, Benevento, Francesca, additional, Granito, Alessandro, additional, Muratori, Luca, additional, Piscaglia, Fabio, additional, Tovoli, Francesco, additional, Allegrini, Gloria, additional, Cammà, Calogero, additional, Cabibbo, Giuseppe, additional, Giacchetto, Carmelo Marco, additional, Giuffrida, Paolo, additional, Grassini, Maria Vittoria, additional, Grova, Mauro, additional, Rancatore, Gabriele, additional, Stornello, Caterina, additional, Adotti, Valentina, additional, Cavoli, Tancredi Li, additional, Marra, Fabio, additional, Rosi, Martina, additional, Bevilacqua, Vittoria, additional, Borghi, Alberto, additional, Napoli, Lucia, additional, Conti, Fabio, additional, Frassineti, G.L., additional, Migliano, Maria Teresa, additional, de Matthaeis, Nicoletta, additional, Ponziani, Francesca Romana, additional, Missale, Gabriele, additional, Olivani, Andrea, additional, Capasso, Mario, additional, Cossiga, Valentina, additional, Guarino, Maria, additional, Marina Cela, Ester, additional, Facciorusso, Antonio, additional, Graziosi, Camilla, additional, Lauria, Valentina, additional, Pelecca, Giorgio, additional, Schirripa, Marta, additional, Chegai, Fabrizio, additional, Raso, Armando, additional, Bozzi, Alessio, additional, Franzè, Maria Stella, additional, Saitta, Carlo, additional, Sauchella, Assunta, additional, Dajti, Elton, additional, Ravaioli, Federico, additional, Plaz Torres, Maria Corina, additional, Pieri, Giulia, additional, Oliveri, Filippo, additional, Ricco, Gabriele, additional, Romagnoli, Veronica, additional, Inno, Alessandro, additional, Marchetti, Fabiana, additional, Coccoli, Pietro, additional, Malerba, Antonio, additional, Cappelli, Alberta, additional, Golfieri, Rita, additional, Mosconi, Cristina, additional, and Renzulli, Matteo, additional
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- 2023
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7. Utility of Tumor Burden Score to Stratify Prognosis of Patients with Hepatocellular Cancer: Results of 4759 Cases from ITA.LI.CA Study Group
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Vitale, Alessandro, Lai, Quirino, Farinati, Fabio, Bucci, Laura, Giannini, Edoardo G., Napoli, Lucia, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, 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, Pawlik, Timothy M., and On behalf of the Italian Liver Cancer (ITA.LI.CA) group
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- 2018
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8. Recalibrating survival prediction among patients receiving trans‐arterial chemoembolization for hepatocellular carcinoma
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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
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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.
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- 2021
9. Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma
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Giannini, Edoardo G., primary, Pieri, Giulia, additional, Labanca, Sara, additional, Plaz Torres, Maria Corina, additional, Gasbarrini, Antonio, additional, Biasini, Elisabetta, additional, Campani, Claudia, additional, Cazzagon, Nora, additional, Foschi, Francesco Giuseppe, additional, Mega, Andrea, additional, Masotto, Alberto, additional, Raimondo, Giovanni, additional, Rapaccini, Gian Ludovico, additional, Sacco, Rodolfo, additional, Caturelli, Eugenio, additional, Guarino, Maria, additional, Tovoli, Francesco, additional, Vidili, Gianpaolo, additional, Brunetto, Maurizia Rossana, additional, Nardone, Gerardo, additional, Svegliati-Baroni, Gianluca, additional, Magalotti, Donatella, additional, Azzaroli, Francesco, additional, Cabibbo, Giuseppe, additional, Di Marco, Maria, additional, Sangiovanni, Angelo, additional, Trevisani, Franco, additional, Biselli, Maurizio, additional, Caraceni, Paolo, additional, Gramenzi, Annagiulia, additional, Benevento, Francesca, additional, Granito, Alessandro, additional, Muratori, Luca, additional, Piscaglia, Fabio, additional, Bertellini, Federica, additional, Farinati, Fabio, additional, Palano, Giorgio, additional, Pelizzaro, Filippo, additional, Penzo, Barbara, additional, Pinto, Elisa, additional, Allegrini, Gloria, additional, Cammà, Calogero, additional, Celsa, Ciro, additional, Giuffrida, Paolo, additional, Stornello, Caterina, additional, Grova, Mauro, additional, Giacchetto, Carmelo Marco, additional, Rancatore, Gabriele, additional, Grassini, Maria Vittoria, additional, Adotti, Valentina, additional, Gitto, Stefano, additional, Marra, Fabio, additional, Rosi, Martina, additional, Bevilacqua, Vittoria, additional, Borghi, Alberto, additional, Gardini, Andrea Casadei, additional, Conti, Fabio, additional, Napoli, Lucia, additional, Domenicali, Marco, additional, Migliano, Maria Teresa, additional, de Matthaeis, Nicoletta, additional, Ponziani, Francesca Romana, additional, Olivani, Andrea, additional, Missale, Gabriele, additional, Cossiga, Valentina, additional, Capasso, Mario, additional, Morisco, Filomena, additional, Cela, Ester Marina, additional, Facciorusso, Antonio, additional, Lauria, Valentina, additional, Ghittoni, Giorgia, additional, Pelecca, Giorgio, additional, Chegai, Fabrizio, additional, Coratella, Fabio, additional, Ortenzi, Mariano, additional, Dell'Isola, Serena, additional, Franzè, Maria Stella, additional, Saitta, Carlo, additional, Sauchella, Assunta, additional, Dajti, Elton, additional, Ravaioli, Federico, additional, Oliveri, Filippo, additional, Ricco, Gabriele, additional, Romagnoli, Veronica, additional, Inno, Alessandro, additional, Marchetti, Fabiana, additional, Coccoli, Pietro, additional, Malerba, Antonio, additional, Cappelli, Alberta, additional, Golfieri, Rita, additional, Mosconi, Cristina, additional, and Renzulli, Matteo, additional
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- 2022
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10. Transarterial Chemoembolization for Hepatocellular Carcinoma in Clinical Practice: Temporal Trends and Survival Outcomes of an Iterative Treatment
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Pelizzaro, Filippo, Haxhi, Selion, Penzo, Barbara, Vitale, Alessandro, Giannini, Edoardo G, Sansone, Vito, Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, Eugenio, Magalotti, Donatella, Sacco, Rodolfo, Celsa, Ciro, Campani, Claudia, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Trevisani, Franco, Farinati, Fabio, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Di Marco, Maria, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Pelizzaro, Filippo, Haxhi, Selion, Penzo, Barbara, Vitale, Alessandro, Giannini, Edoardo G, Sansone, Vito, Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, Eugenio, Magalotti, Donatella, Sacco, Rodolfo, Celsa, Ciro, Campani, Claudia, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Trevisani, Franco, Farinati, Fabio, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Di Marco, Maria, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
- Abstract
BackgroundTransarterial chemoembolization (TACE) is one of the most frequently applied treatments for hepatocellular carcinoma (HCC) worldwide. In this study, we aimed at evaluating whether and how TACE application and repetition, as well as the related outcome, have changed over the last three decades in Italy. MethodsData of 7,184 patients with HCC were retrieved from the Italian Liver Cancer (ITA.LI.CA) database. Patients were divided according to the period of diagnosis in six cohorts: P1 (1988-1993), P2 (1994-1998), P3 (1999-2004), P4 (2005-2009), P5 (2010-2014), and P6 (2015-2019). All the analyses were repeated in the overall patient population and in Barcelona Clinic Liver Cancer (BCLC) B patients, who are the subgroup of HCC patients originally supposed to receive TACE according to guidelines. TACE was defined as either the first or the main (more effective) treatment. ResultsThe proportion of patients receiving TACE as first or main therapy declined over time, and less than 50% of BCLC B patients were treated with chemoembolization from P3 onward. Conversely, TACE was widely used even outside the intermediate stage. Survival of TACE-treated patients progressively increased from P1 to P6. Although TACE was performed only once in the majority of patients, there was an increasing proportion of those receiving 2 or >= 3 treatments sessions over time. The overall survival (OS) of patients undergoing repeated treatments was significantly higher compared to those managed with a single TACE (median OS 40.0 vs. 65.0 vs. 71.8 months in 1, 2, and >= 3 TACE groups, respectively; p < 0.0001). However, after a first-line TACE, the adoption of curative therapies provided longer survival than repeating TACE (83.0 vs. 42.0 months; p < 0.0001), which in turn was associated with better outcomes compared to systemic therapies or best supportive care (BSC). ConclusionsDespite a decline in the percentage of treated patients over time, TACE has still an important rol
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- 2022
11. Surveillance for hepatocellular carcinoma with a 3-months interval in 'extremely high-risk' patients does not further improve survival
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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 Teresa, 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, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Di Marco, Maria, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), 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 Teresa, 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, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Di Marco, Maria, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
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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. (C) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- 2022
12. Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma
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Giannini, Edoardo G, Pieri, Giulia, Labanca, Sara, Plaz Torres, Maria Corina, Gasbarrini, Antonio, Biasini, Elisabetta, Campani, Claudia, Cazzagon, Nora, Foschi, Francesco Giuseppe, Mega, Andrea, Masotto, Alberto, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Sacco, Rodolfo, Caturelli, Eugenio, Guarino, Maria, Tovoli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Svegliati-Baroni, Gianluca, Magalotti, Donatella, Azzaroli, Francesco, Cabibbo, Giuseppe, Di Marco, Maria Teresa, Sangiovanni, Angelo, Trevisani, Franco, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Di Marco, Maria, Giannini, Edoardo G, Pieri, Giulia, Labanca, Sara, Plaz Torres, Maria Corina, Gasbarrini, Antonio, Biasini, Elisabetta, Campani, Claudia, Cazzagon, Nora, Foschi, Francesco Giuseppe, Mega, Andrea, Masotto, Alberto, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Sacco, Rodolfo, Caturelli, Eugenio, Guarino, Maria, Tovoli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Svegliati-Baroni, Gianluca, Magalotti, Donatella, Azzaroli, Francesco, Cabibbo, Giuseppe, Di Marco, Maria Teresa, Sangiovanni, Angelo, Trevisani, Franco, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), and Di Marco, Maria
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Background: Comprehensive and contemporary data pertaining large populations of patients with Primary Biliary Cholangitis (PBC) and hepatocellular carcinoma (HCC) are missing. Aim: To describe main characteristics and outcome of PBC patients with HCC diagnosed in the new millennium. Methods: Analysing the Italian Liver Cancer registry we identified 80 PBC patients with HCC diagnosed after the year 2000, and described their clinical characteristics, access to treatment and survival. Results: Median age of patients was 71 years and 50.0% were males. Cirrhosis was present in 86.3% of patients, being well-compensated in 58.0%. Median HCC diameter was smaller in patients under surveillance (2.6 vs 4.0 cm, P = 0.007). Curative treatment, feasible in 50.0% of patients, was associated with improved survival compared to palliative and supportive care (42 vs 33 vs 6 months, P<0.0001). Surveillance was associated with a non-significant improved survival (36 vs 23 months), likely due to similar rate of curative treatment in patients under (51.4%) and outside surveillance (42.6%). Conclusions: PBC patients with HCC are often elderly males with well-preserved liver function. Feasibility of curative treatment is high and associated with improved prognosis. Description of these patients may help focus surveillance to identify earlier tumours, increase their curability, and improve prognosis.
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- 2022
13. Curative therapies are superior to standard of care (transarterial chemoembolization) for intermediate stage hepatocellular carcinoma
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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, Trevisani, Franco, Bolondi, Luigi, Biselli, Maurizio, Bucci, Laura, Caraceni, Paolo, Cucchetti, Alessandro, Domenicali, Marco, Magalotti, Donatella, Serra, Carla, Venerandi, Laura, Giacomin, Anna, Maddalo, Gemma, Pozzan, Caterina, Vani, Veronica, Poggio, Paolo Del, Olmi, Stefano, Balsamo, Claudia, Vavassori, Elena, Benvegnù, Luisa, Cappelli, Alberta, Golfieri, Rita, Mosconi, Cristina, Renzulli, Matteo, Bosco, Giulia, Roselli, Paola, DellʼIsola, Serena, Ialungo, Anna Maria, Bruzzone, Linda, Picciotto, Antonino, Marenco, Simona, Risso, Domenico, Sammito, Giorgio, Savarino, Vincenzo, Cammà, Calogero, Maida, Marcello, Costantino, Andrea, Barcellona, Maria Rosa, Affronti, Andrea, Mega, Andrea, Rinninella, Emanuele, Mismas, Valeria, Cappa, Federica Mirici, DallʼAglio, Anna Chiara, Feletti, Valentina, Lanzi, Arianna, Neri, Elga, Stefanini, Giuseppe Francesco, Tamberi, Stefano, Missale, Gabriele, Porro, Emanuela, Guarino, Maria, Gemini, Stefano, and Schiadà, Laura
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- 2017
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14. The evolutionary scenario of hepatocellular carcinoma in Italy: an update
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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, and Inghilesi, Andrea Lorenzo
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- 2017
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15. Monofocal hepatocellular carcinoma: How much does size matter?
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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
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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 
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- 2021
16. Transarterial Chemoembolization for Hepatocellular Carcinoma in Clinical Practice: Temporal Trends and Survival Outcomes of an Iterative Treatment
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Pelizzaro, Filippo, primary, Haxhi, Selion, additional, Penzo, Barbara, additional, Vitale, Alessandro, additional, Giannini, Edoardo G., additional, Sansone, Vito, additional, Rapaccini, Gian Ludovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Magalotti, Donatella, additional, Sacco, Rodolfo, additional, Celsa, Ciro, additional, Campani, Claudia, additional, Mega, Andrea, additional, Guarino, Maria, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Olivani, Andrea, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Brunetto, Maurizia Rossana, additional, Trevisani, Franco, additional, and Farinati, Fabio, additional
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- 2022
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17. Epidemiological trends and trajectories of MAFLD-associated hepatocellular carcinoma 2002–2033: the ITA.LI.CA database
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Vitale, Alessandro, primary, Svegliati-Baroni, Gianluca, additional, Ortolani, Alessio, additional, Cucco, Monica, additional, Dalla Riva, Giulio V, additional, Giannini, Edoardo G, additional, Piscaglia, Fabio, additional, Rapaccini, Gianludovico, additional, Di Marco, Mariella, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Sacco, Rodolfo, additional, Cabibbo, Giuseppe, additional, Marra, Fabio, additional, Mega, Andrea, additional, Morisco, Filomena, additional, Gasbarrini, Antonio, additional, Foschi, Francesco Giuseppe, additional, Missale, Gabriele, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Oliveri, Filippo, additional, Pelizzaro, Filippo, additional, Ramirez Morales, Rafael, additional, Cillo, Umberto, additional, Trevisani, Franco, additional, Miele, Luca, additional, Marchesini, Giulio, additional, and Farinati, Fabio, additional
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- 2021
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18. Epidemiological trends and trajectories of MAFLD-associated hepatocellular carcinoma 2002-2033: the ITA.LI.CA database.
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Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Riva, Giulio V. Dalla, Giannini, Edoardo G., Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, and Masotto, Alberto
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HEPATOCELLULAR carcinoma ,FATTY liver ,MEDICAL personnel ,HEPATITIS C ,MEDICAL sciences ,MEDICAL specialties & specialists ,NON-alcoholic fatty liver disease - Published
- 2023
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19. Material deprivation affects the management and clinical outcome of hepatocellular carcinoma in a high-resource environment
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Cucchetti, Alessandro, primary, Gramenzi, Annagiulia, additional, Johnson, Philip, additional, Giannini, Edoardo G., additional, Tovoli, Francesco, additional, Rapaccini, Gian Ludovico, additional, Marra, Fabio, additional, Cabibbo, Giuseppe, additional, Caturelli, Eugenio, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Sacco, Rodolfo, additional, Zoli, Marco, additional, Morisco, Filomena, additional, Di Marco, Maria, additional, Mega, Andrea, additional, Foschi, Francesco G., additional, Biasini, Elisabetta, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Brunetto, Maurizia R., additional, Farinati, Fabio, additional, Trevisani, Franco, additional, Avanzato, Francesca, additional, Biselli, Maurizio, additional, Caraceni, Paolo, additional, Garuti, Francesca, additional, Neri, Andrea, additional, Santi, Valentina, additional, Pellizzaro, Filippo, additional, Imondi, Angela, additional, Sartori, Anna, additional, Penzo, Barbara, additional, Sanmarco, Ambra, additional, Granito, Alessandro, additional, Muratori, Luca, additional, Piscaglia, Fabio, additional, Sansone, Vito, additional, Forgione, Antonella, additional, Dajti, Elton, additional, Marasco, Giovanni, additional, Ravaioli, Federico, additional, Cappelli, Alberta, additional, Golfieri, Rita, additional, Mosconi, Cristina, additional, Renzulli, Matteo, additional, Cela, Ester Marina, additional, Facciorusso, Antonio, additional, Cacciato, Valentina, additional, Casagrande, Edoardo, additional, Moscatelli, Alessandro, additional, Pellegatta, Gaia, additional, de Matthaeis, Nicoletta, additional, Allegrini, Gloria, additional, Lauria, Valentina, additional, Ghittoni, Giorgia, additional, Pelecca, Giorgio, additional, Chegai, Fabrizio, additional, Coratella, Fabio, additional, Ortenzi, Mariano, additional, Missale, Gabriele, additional, Olivani, Andrea, additional, Inno, Alessandro, additional, Marchetti, Fabiana, additional, Busacca, Anita, additional, Cammà, Calogero, additional, Di Martino, Vincenzo, additional, Maria Rizzo, Giacomo Emanuele, additional, Franzè, Maria Stella, additional, Saitta, Carlo, additional, Sauchella, Assunta, additional, Berardinelli, Dante, additional, Bevilacqua, Vittoria, additional, Borghi, Alberto, additional, Gardini, Andrea Casadei, additional, Conti, Fabio, additional, Dall'Aglio, Anna Chiara, additional, Ercolani, Giorgio, additional, Adotti, Valentina, additional, Arena, Umberto, additional, Di Bonaventura, Chiara, additional, Campani, Claudia, additional, Dragoni, Gabriele, additional, Gitto, Stefano, additional, Laffi, Giacomo, additional, Coccoli, Pietro, additional, Malerba, Antonio, additional, Guarino, Maria, additional, Capasso, Maria, additional, Oliveri, Filippo, additional, and Romagnoli, Veronica, additional
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- 2021
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20. Surveillance for hepatocellular carcinoma with a 3-months interval in “extremely high-risk” patients does not further improve survival
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Pelizzaro, Filippo, primary, Peserico, Giulia, additional, D'Elia, Marco, additional, Cazzagon, Nora, additional, Russo, Francesco Paolo, additional, Vitale, Alessandro, additional, Giannini, Edoardo G., additional, Piccinnu, Manuela, additional, Rapaccini, Gian Ludovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Sacco, Rodolfo, additional, Cabibbo, Giuseppe, additional, Marra, Fabio, additional, Mega, Andrea, additional, Morisco, Filomena, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Olivani, Andrea, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Oliveri, Filippo, additional, Trevisani, Franco, additional, and Farinati, Fabio, additional
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- 2021
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21. Correction: Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma
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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, and and the Italian Liver Cancer (ITA.LI.CA) Group
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- 2018
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22. Surveillance as determinant of long-term survival in non-transplanted hepatocellular carcinoma patients
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Pelizzaro, Filippo, Vitale, Alessandro, Sartori, Anna, Vieno, Andrea, Penzo, Barbara, Russo, Francesco, Frigo, Anna, Giannini, Edoardo, Piccinnu, Manuela, Rapaccini, Gian, Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Celsa, Ciro, Marra, Fabio, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco, Olivani, Andrea, Masotto, Alberto, Coccoli, Pietro, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia, Trevisani, Franco, Farinati, Fabio, Group, on behalf of ITA.LI.CA study, Pelizzaro F., Vitale A., Sartori A., Vieno A., Penzo B., Russo F.P., Frigo A.C., Giannini E.G., Piccinnu M., Rapaccini G.L., Di Marco M., Caturelli E., Zoli M., Sacco R., Celsa C., Marra F., Mega A., Guarino M., Gasbarrini A., Svegliati-Baroni G., Foschi F.G., Olivani A., Masotto A., Coccoli P., Raimondo G., Azzaroli F., Vidili G., Brunetto M.R., Trevisani F., and Farinati F.
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Cancer Research ,medicine.medical_specialty ,Hepatocellular carcinoma ,Settore MED/12 - GASTROENTEROLOGIA ,Cancer stage ,Independent predictor ,Logistic regression ,lcsh:RC254-282 ,Article ,03 medical and health sciences ,Long-term survival ,0302 clinical medicine ,Internal medicine ,Long term survival ,medicine ,Treatment ,Surveillance ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Confounding ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Oncology ,030220 oncology & carcinogenesis ,Baseline characteristics ,030211 gastroenterology & hepatology ,business - Abstract
Purpose: We aimed at assessing the impact of surveillance on long-term survival in HCC patients. Methods: From the ITA.LI.CA database, we selected 1028 cases with long (≥5 years, LS group) and 2721 controls with short-term survival (<, 5 years, SS group). The association between surveillance and LS was adjusted for confounders by multivariable logistic regression analysis. Survival of surveilled patients was presented both as observed and corrected for the lead-time bias, and the comparison of survival between surveillance and no surveillance groups was also performed after balancing the baseline characteristics with inverse probability weights (IPW). Results: LS patients were more frequently diagnosed under surveillance (p <, 0.0001), and had more favorable baseline characteristics. Surveillance was an independent predictor of LS (OR = 1.413, 95% CI 1.195–1.671, p <, 0.0001). The observed and the lead-time corrected survival of surveilled patients were significantly longer compared to the survival of not surveilled patients (p <, 0.0001 and p = 0.0008, respectively). In IPW adjusted populations, no survival differences were demonstrated between the two groups (p = 0.30). Conclusions: Surveillance, increasing early-stage diagnosis and applicability of curative treatments, is a fundamental determinant of long-term survival in HCC patients. A wide implementation of surveillance programs should be pursued in order to improve HCC patients’ prognosis.
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- 2021
23. Epidemiological trends and trajectories of MAFLD-associated hepatocellular carcinoma 2002-2033: the ITA.LI.CA database
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Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Dalla Riva, Giulio V, Giannini, Edoardo G, Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Pelizzaro, Filippo, Ramirez Morales, Rafael, Cillo, Umberto, Trevisani, Franco, Miele, Luca, Marchesini, Giulio, Farinati, Fabio, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Miele, Luca (ORCID:0000-0003-3464-0068), Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Dalla Riva, Giulio V, Giannini, Edoardo G, Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Pelizzaro, Filippo, Ramirez Morales, Rafael, Cillo, Umberto, Trevisani, Franco, Miele, Luca, Marchesini, Giulio, Farinati, Fabio, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Miele, Luca (ORCID:0000-0003-3464-0068)
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Background Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a new inclusive definition of the whole spectrum of liver diseases associated to metabolic disorders. The main objective of this study was to compare patients with MAFLD and non-MAFLD with hepatocellular carcinoma (HCC) included in a nationally representative cohort. Methods We analysed 6882 consecutive patients with HCC enrolled from 2002 to 2019 by 23 Italian Liver Cancer centres to compare epidemiological and future trends in three subgroups: pure, single aetiology MAFLD (S-MAFLD); mixed aetiology MAFLD (metabolic and others, M-MAFLD); and non-MAFLD HCC. Results MAFLD was diagnosed in the majority of patients with HCC (68.4%). The proportion of both total MAFLD and S-MAFLD HCC significantly increased over time (from 50.4% and 3.6% in 2002-2003, to 77.3% and 28.9% in 2018-2019, respectively, p<0.001). In Italy S-MAFLD HCC is expected to overcome M-MAFLD HCC in about 6 years. Patients with S-MAFLD HCC were older, more frequently men and less frequently cirrhotic with clinically relevant portal hypertension and a surveillance-related diagnosis. They had more frequently large tumours and extrahepatic metastases. After weighting, and compared with patients with non-MAFLD, S-MAFLD and M-MAFLD HCC showed a significantly lower overall (p=0.026, p=0.004) and HCC-related (p<0.001, for both) risk of death. Patients with S-MAFLD HCC showed a significantly higher risk of non-HCC-related death (p=0.006). Conclusions The prevalence of MAFLD HCC in Italy is rapidly increasing to cover the majority of patients with HCC. Despite a less favourable cancer stage at diagnosis, patients with MAFLD HCC have a lower risk of HCC-related death, suggesting reduced cancer aggressiveness.
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- 2021
24. Changes in hepatocellular carcinoma aggressiveness characteristics with an increase in tumor diameter
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Carr, Brian I., primary, Guerra, Vito, additional, Donghia, Rossella, additional, Farinati, Fabio, additional, Giannini, Edoardo G., additional, Piscaglia, Fabio, additional, Rapaccini, Gian Ludovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Sacco, Rodolfo, additional, Cabibbo, Giuseppe, additional, Marra, Fabio, additional, Mega, Andrea, additional, Morisco, Filomena, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Missale, Gabriele, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Oliveri, Filippo, additional, and Trevisani, Franco, additional
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- 2021
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25. Identification of Clinical Phenotypes and Related Survival in Patients with Large HCCs
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Carr, Brian I., primary, Guerra, Vito, additional, Donghia, Rossella, additional, Farinati, Fabio, additional, Giannini, Edoardo G., additional, Muratori, Luca, additional, Rapaccini, Gian Ludovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Sacco, Rodolfo, additional, Celsa, Ciro, additional, Campani, Claudia, additional, Mega, Andrea, additional, Guarino, Maria, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Biasini, Elisabetta, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Raimondo, Giovanni, additional, Azzaroli, Francesco, additional, Vidili, Gianpaolo, additional, Brunetto, Maurizia Rossana, additional, and Trevisani, Franco, additional
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- 2021
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26. Development and Validation of a New Prognostic System for Patients with Hepatocellular Carcinoma
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Farinati, Fabio, Vitale, Alessandro, Spolverato, Gaya, Pawlik, Timothy M., Huo, Teh-la, Lee, Yun-Hsuan, Frigo, Anna Chiara, Giacomin, Anna, Giannini, Edoardo G., Ciccarese, Francesca, Piscaglia, Fabio, Rapaccini, Gian Lodovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Cabibbo, Giuseppe, Felder, Martina, Sacco, Rodolfo, Morisco, Filomena, Biasini, Elisabetta, Foschi, Francesco Giuseppe, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Virdone, Roberto, Masotto, Alberto, Trevisani, Franco, and Cillo, Umberto
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Glycoproteins -- Physiological aspects -- Research ,Hepatocellular carcinoma -- Prognosis -- Care and treatment -- Research ,Biological sciences - Abstract
Background Prognostic assessment in patients with hepatocellular carcinoma (HCC) remains controversial. Using the Italian Liver Cancer (ITA.LI.CA) database as a training set, we sought to develop and validate a new prognostic system for patients with HCC. Methods and Findings Prospective collected databases from Italy (training cohort, n = 3,628; internal validation cohort, n = 1,555) and Taiwan (external validation cohort, n = 2,651) were used to develop the ITA.LI.CA prognostic system. We first defined ITA.LI.CA stages (0, A, B1, B2, B3, C) using only tumor characteristics (largest tumor diameter, number of nodules, intra- and extrahepatic macroscopic vascular invasion, extrahepatic metastases). A parametric multivariable survival model was then used to calculate the relative prognostic value of ITA.LI.CA tumor stage, Eastern Cooperative Oncology Group (ECOG) performance status, Child-Pugh score (CPS), and alpha-fetoprotein (AFP) in predicting individual survival. Based on the model results, an ITA.LI.CA integrated prognostic score (from 0 to 13 points) was constructed, and its prognostic power compared with that of other integrated systems (BCLC, HKLC, MESIAH, CLIP, JIS). Median follow-up was 58 mo for Italian patients (interquartile range, 26-106 mo) and 39 mo for Taiwanese patients (interquartile range, 12-61 mo). The ITA.LI.CA integrated prognostic score showed optimal discrimination and calibration abilities in Italian patients. Observed median survival in the training and internal validation sets was 57 and 61 mo, respectively, in quartile 1 (ITA.LI.CA score [less than or equal to] 1), 43 and 38 mo in quartile 2 (ITA.LI.CA score 2-3), 23 and 23 mo in quartile 3 (ITA.LI.CA score 4-5), and 9 and 8 mo in quartile 4 (ITA.LI.CA score > 5). Observed and predicted median survival in the training and internal validation sets largely coincided. Although observed and predicted survival estimations were significantly lower (log-rank test, p < 0.001) in Italian than in Taiwanese patients, the ITA.LI.CA score maintained very high discrimination and calibration features also in the external validation cohort. The concordance index (C index) of the ITA.LI.CA score in the internal and external validation cohorts was 0.71 and 0.78, respectively. The ITA.LI.CA score's prognostic ability was significantly better (p < 0.001) than that of BCLC stage (respective C indexes of 0.64 and 0.73), CLIP score (0.68 and 0.75), JIS stage (0.67 and 0.70), MESIAH score (0.69 and 0.77), and HKLC stage (0.68 and 0.75). The main limitations of this study are its retrospective nature and the intrinsically significant differences between the Taiwanese and Italian groups. Conclusions The ITA.LI.CA prognostic system includes both a tumor staging-stratifying patients with HCC into six main stages (0, A, B1, B2, B3, and C)-and a prognostic score-integrating ITA.LI.CA tumor staging, CPS, ECOG performance status, and AFP. The ITA.LI.CA prognostic system shows a strong ability to predict individual survival in European and Asian populations., Author(s): Fabio Farinati 1, Alessandro Vitale 1,*, Gaya Spolverato 1, Timothy M. Pawlik 2, Teh-la Huo 3,4, Yun-Hsuan Lee 3,4, Anna Chiara Frigo 5, Anna Giacomin 1, Edoardo G. Giannini [...]
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- 2016
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27. Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma
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Cabibbo, Giuseppe, Petta, Salvatore, Barbara, Marco, Attardo, Simona, Bucci, Laura, Farinati, Fabio, Giannini, Edoardo G., Negrini, Giulia, Ciccarese, Francesca, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Virdone, Roberto, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Benvegnã¹, Luisa, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Persico, Marcello, Craxã¬, Antonio, Trevisani, Franco, Cammã , Calogero, Cabibbo, G., Petta, S., Barbara, M., Attardo, S., Bucci, L., Farinati, F., Giannini, E., Negrini, G., Ciccarese, F., Rapaccini, G., Di Marco, M., Caturelli, E., Zoli, M., Borzio, F., Sacco, R., Virdone, R., Marra, F., Mega, A., Morisco, F., Benvegnã¹, L., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F., Olivani, A., Masotto, A., Nardone, G., Colecchia, A., Persico, M., Craxi, A., Trevisani, F., Camma', C., G. Cabibbo, S. Petta, M. Barbara, S. Attardo, L. Bucci, F. Farinati, E. G. Giannini, G. Negrini, F. Ciccarese, G. L. Rapaccini, M. Di Marco, E. Caturelli, M. Zoli, F. Borzio, R. Sacco, R. Virdone, F. Marra, A. Mega, F. Morisco, L. Benvegnù, A. Gasbarrini, G. Svegliati-Baroni, F. G. Foschi, A. Olivani, A. Masotto, G. Nardone, A. Colecchia, M. Persico, A. Craxì, F. Trevisani, C. Cammà, Cabibbo, Giuseppe, Petta, Salvatore, Barbara, Marco, Attardo, Simona, Bucci, Laura, Farinati, Fabio, Giannini, Edoardo G, Negrini, Giulia, Ciccarese, Francesca, Lodovico Rapaccini, Gian, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Virdone, Roberto, Marra Mega, Fabio Andrea, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Giuseppe Foschi, Francesco, Olivani, Andrea, Masotto, Alberto, Nardone, GERARDO ANTONIO PIO, Colecchia, Antonio, Persico, Marcello, Craxì, Antonio, Trevisani, Franco, and Cammà, Calogero
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Liver Cirrhosis ,Male ,Hepatocellular Carcinoma, Liver Cirrhosis, hepatitis C virus, Survival, direct-acting antiviral agents ,Survival rate ,Cirrhosis ,Antiviral agent ,Gastroenterology ,Liver cirrhosi ,0302 clinical medicine ,Recurrence ,Hepatic decompensation ,Hepatitis C Virus (HCV) ,Hepatocellular carcinoma (HCC) ,Prognosis ,Recurrences ,Sustained virological response (SVR) ,overall survival (OS) ,Overall survival ,Liver Neoplasms ,Hepatitis C ,Middle Aged ,Sustained virological response ,Local ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,Female ,Antiviral agents ,Carcinoma, hepatocellular ,Liver cirrhosis ,Aged ,Carcinoma, Hepatocellular ,Humans ,Neoplasm Recurrence, Local ,Proportional Hazards Models ,Liver cancer ,medicine.medical_specialty ,Prognosi ,Settore MED/12 - GASTROENTEROLOGIA ,03 medical and health sciences ,hepatocellular ,Internal medicine ,medicine ,Early Hepatocellular Carcinoma ,Hepatology ,business.industry ,Carcinoma ,Hepatocellular ,medicine.disease ,digestive system diseases ,Neoplasm Recurrence ,Liver function ,business - Abstract
Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12Âmonths of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BCLC stage 0/A HCC who had complete radiological response after curative resection or thermal ablation were prospectively recruited to this study. Primary endpoint of the study was 5-year OS. Independent baseline and time-dependent predictors of 5-year OS were identified by Cox model. Results The observed 5-year survival rate was 44%. The observed HCC early recurrence and early hepatic decompensation rate were 21% and 10%, respectively. Early hepatic decompensation (Hazard Ratio [HR] 7.52; 95% confidence intervals (CI): 1.23â13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23â5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02â2.70) and age (HR 1.04; 95% CI: 1.02â1.07) were significantly associated with the 5-year OS. Conclusion Survival in HCV-infected patients with cirrhosis and successfully treated HCC is influenced by early hepatic decompensation. Our study indirectly suggests that direct-acting antiviral agents could improve OS of HCC patients through long-term preservation of liver function, resulting in a lower cirrhosis-related mortality and a greater change of receiving curative treatments. Lay summary Survival in hepatitis C virus (HCV) infected patients with cirrhosis and successfully treated hepatocellular carcinoma (HCC), is mainly influenced by early hepatic decompensation. HCV eradication after treatment with new direct-acting antiviral agents could improve overall survival of HCC patients through long-term preservation of liver function.
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- 2017
28. A meta-analysis of single HCV-untreated arm of studies evaluating outcomes after curative treatments of HCV-related hepatocellular carcinoma
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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.
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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.
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- 2017
29. Pattern of macrovascular invasion in hepatocellular carcinoma.
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Guarino, Maria, Cucchetti, Alessandro, Pontillo, Giuseppina, Farinati, Fabio, Benevento, Francesca, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Rodolfo, Sacco, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Gasbarrini, Antonio, Svegliati‐Baroni, Gianluca, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, and Raimondo, Giovanni
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OVERALL survival ,SURVIVAL rate ,HEPATOCELLULAR carcinoma ,RECURSIVE partitioning ,LIVER cancer ,DECISION trees - Abstract
Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008‐2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter‐relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0 months (95% CI, 5.1‐7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4 months in those with PS > 1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1 months in patients with PS 0‐1, no ascites and Vp1‐Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions. [ABSTRACT FROM AUTHOR]
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- 2021
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30. Correction to: Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma (The American Journal of Gastroenterology, (2016), 111, 1, (70-77), 10.1038/ajg.2015.389)
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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, and Trevisani, Franco
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Hepatology ,Gastroenterology - Published
- 2018
31. The concept of therapeutic hierarchy for patients with hepatocellular carcinoma: A multicenter cohort study
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Vitale, Alessandro, primary, Farinati, Fabio, additional, Pawlik, Timothy M., additional, Frigo, Anna Chiara, additional, Giannini, Edoardo G., additional, Napoli, Lucia, additional, Ciccarese, Francesco, additional, Rapaccini, Gian Ludovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Borzio, Franco, additional, Sacco, Rodolfo, additional, Cabibbo, Giuseppe, additional, Virdone, Roberto, additional, Marra, Fabio, additional, Felder, Martina, additional, Morisco, Filomena, additional, Benvegnù, Luisa, additional, Gasbarrini, Antonio, additional, Svegliati‐Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Missale, Gabriele, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Colecchia, Antonio, additional, Bernardi, Mauro, additional, Trevisani, Franco, additional, and Cillo, Umberto, additional
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- 2019
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32. Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma
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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
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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
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- 2016
33. Restaging Patients With Hepatocellular Carcinoma Before Additional Treatment Decisions: A Multicenter Cohort Study
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Vitale, Alessandro, Farinati, Fabio, Noaro, Giulia, Burra, Patrizia, Pawlik, Timothy M., Bucci, Laura, Giannini, Edoardo G., Faggiano, Chiara, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Fornari, Fabio, Marignani, Massimo, Vicari, Susanna, Bortolini, Emanuela, Cozzolongo, Raffaele, Grasso, Alessandro Giovanni, Aliberti, Camillo, Bernardi, Mauro, Frigo, Anna Chiara, Borzio, Mauro, Trevisani, Franco, Cillo, Umberto, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Vitale, Alessandro, Farinati, Fabio, Noaro, Giulia, Burra, Patrizia, Pawlik, Timothy M., Bucci, Laura, Giannini, Edoardo G., Faggiano, Chiara, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Fornari, Fabio, Marignani, Massimo, Vicari, Susanna, Bortolini, Emanuela, Cozzolongo, Raffaele, Grasso, Alessandro Giovanni, Aliberti, Camillo, Bernardi, Mauro, Frigo, Anna Chiara, Borzio, Mauro, Trevisani, Franco, Cillo, Umberto, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
- Abstract
Prognostic assessment of patients with hepatocellular carcinoma (HCC) at the time of diagnosis remains controversial and becomes even more complex at the time of restaging when new variables need to be considered. The aim of the current study was to evaluate the prognostic utility of restaging patients before proceeding with additional therapies for HCC. Two independent Italian prospective databases were used to identify 1,196 (training cohort) and 648 (validation cohort) consecutive patients with HCC treated over the same study period (2008-2015) who had complete restaging before decisions about additional therapies. The performance of the Italian Liver Cancer (ITA.LI.CA) prognostic score at restaging was compared with that of the Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, and Cancer of the Liver Italian Program systems. A multivariable Cox survival analysis was performed to identify baseline, restaging, or dynamic variables that were able to improve the predictive performance of the prognostic systems. At restaging, 35.3% of patients maintained stable disease; most patients were either down-staged by treatment (27.2%) or had disease progression (37.5%). The ITA.LI.CA scoring system at restaging demonstrated the best prognostic performance in both the training and validation cohorts (c-index 0.707 and 0.722, respectively) among all systems examined. On multivariable analysis, several variables improved the prognostic ability of the ITA.LI.CA score at restaging, including progressive disease after the first treatment, Model for End-Stage Liver Disease at restaging, and choice of nonsurgical treatment as additional therapy. A new ITA.LI.CA restaging model was created that demonstrated high discriminative power in both the training and validation cohorts (c-index 0.753 and 0.745, respectively). Conclusion: Although the ITA.LI.CA score demonstrated the best prognostic performance at restaging, other variables should be considered to improve the prognostic a
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- 2018
34. Patients with advanced hepatocellular carcinoma need a personalized management: A lesson from clinical practice
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Giannini, Edoardo G, Bucci, Laura, Garuti, Francesca, Brunacci, Matteo, Lenzi, Barbara, Valente, Matteo, Caturelli, Eugenio, Cabibbo, Giuseppe, Piscaglia, Fabio, Virdone, Roberto, Felder, Martina, Ciccarese, Francesca, Foschi, Francesco Giuseppe, Sacco, Rodolfo, Baroni, Gianluca Svegliati, Farinati, Fabio, Rapaccini, Gian Ludovico, Olivani, Andrea, Gasbarrini, Antonio, Di Marco, Maria, Morisco, Filomena, Zoli, Marco, Masotto, Alberto, Borzio, Franco, Benvegnù, Luisa, Marra, Fabio, Colecchia, Antonio, Nardone, Gerardo, Bernardi, Mauro, Trevisani, Franco, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Giannini, Edoardo G, Bucci, Laura, Garuti, Francesca, Brunacci, Matteo, Lenzi, Barbara, Valente, Matteo, Caturelli, Eugenio, Cabibbo, Giuseppe, Piscaglia, Fabio, Virdone, Roberto, Felder, Martina, Ciccarese, Francesca, Foschi, Francesco Giuseppe, Sacco, Rodolfo, Baroni, Gianluca Svegliati, Farinati, Fabio, Rapaccini, Gian Ludovico, Olivani, Andrea, Gasbarrini, Antonio, Di Marco, Maria, Morisco, Filomena, Zoli, Marco, Masotto, Alberto, Borzio, Franco, Benvegnù, Luisa, Marra, Fabio, Colecchia, Antonio, Nardone, Gerardo, Bernardi, Mauro, Trevisani, Franco, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
- Abstract
N/A
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- 2018
35. Hepatocellular carcinoma recurrence in patients with curative resection or ablation: impact of HCV eradication does not depend on the use of interferon
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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.
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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;]
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- 2017
36. Plasma cholesterol and lipoprotein levels in relation to tumor aggressiveness and survival in HCC patients
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Carr, Brian I., primary, Giannelli, Gianluigi, additional, Guerra, Vito, additional, Giannini, Edoardo G, additional, Farinati, Fabio, additional, Rapaccini, Gian Ludovico, additional, Marco, Maria Di, additional, Zoli, Marco, additional, Caturelli, Eugenio, additional, Masotto, Alberto, additional, Virdone, Roberto, additional, Sacco, Rodolfo, additional, and Trevisani, Franco, additional
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- 2018
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37. Time-Varying mHAP-III Is the Most Accurate Predictor of Survival in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization
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Campani, Claudia, Vitale, Alessandro, Dragoni, Gabriele, Arena, Umberto, Laffi, Giacomo, Cillo, Umberto, Giannini, Edoardo G., Tovoli, Francesco, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Biasini, Elisabetta, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Farinati, Fabio, Trevisani, Franco, and Marra, Fabio
- Abstract
Introduction:The prognosis of patients undergoing transarterial chemoembolization (TACE) is extremely variable, and a confounding factor is that TACE is often repeated several times. We retrospectively evaluated the accuracy of different prognostic scores and staging systems in estimating overall survival (OS) in patients with hepatocellular carcinoma (HCC). Methods:An analysis considering prognostic models as time-varying variables was performed, calculating OS from the time of TACE to the time of the subsequent treatment. Total follow-up time for each patient was therefore split into several observation times accounting for each TACE procedure. Values of the likelihood ratio test (LRT) and Akaike information criterion (AIC) were used to compare different systems. Univariable and multivariable analyses were conducted to identify additional factors predictive of OS. We analyzed 1,610 TACE performed in 1,058 patients recorded in the Italian Liver Cancer database from 2008 through 2016. Results:The median OS of the enrolled patients was 41 months. According to LRT χ
2 and AIC values based on the time-varying analysis, mHAP-III achieved the best values (41.72 and 4,625.49, respectively, p< 0.0001), indicating the highest predictive performance compared with all other scores (HAP, mHAP-II, ALBI, and pALBI) and staging systems (MELD, ITALICA, CLIP, MESH, MESIAH, JIS, HKLC, and BCLC). In the multivariable Cox proportional hazards model, mHAP-III maintained an independent effect on OS (hazard ratio 1.31, 95% CI: 1.10–1.55, p< 0.0001). Time-varying age, alcoholic etiology, radiologic response to TACE, and performing ablation or surgery after TACE were additional significant variables resulting from the multivariable model. Conclusion:An innovative time-varying analysis revealed that mHAP-III was the most accurate model in predicting OS in patients with HCC undergoing TACE. Other clinical pre- and post-TACE variables were also found to be relevant for this prediction.- Published
- 2021
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38. Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma
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Cabibbo, Giuseppe, primary, Petta, Salvatore, additional, Barbara, Marco, additional, Attardo, Simona, additional, Bucci, Laura, additional, Farinati, Fabio, additional, Giannini, Edoardo G., additional, Negrini, Giulia, additional, Ciccarese, Francesca, additional, Rapaccini, Gian Lodovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Borzio, Franco, additional, Sacco, Rodolfo, additional, Virdone, Roberto, additional, Marra, Fabio, additional, Mega, Andrea, additional, Morisco, Filomena, additional, Benvegnù, Luisa, additional, Gasbarrini, Antonio, additional, Svegliati-Baroni, Gianluca, additional, Foschi, Francesco Giuseppe, additional, Olivani, Andrea, additional, Masotto, Alberto, additional, Nardone, Gerardo, additional, Colecchia, Antonio, additional, Persico, Marcello, additional, Craxì, Antonio, additional, Trevisani, Franco, additional, and Cammà, Calogero, additional
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- 2017
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39. Curative therapies are superior to standard of care (transarterial chemoembolization) for intermediate stage hepatocellular carcinoma
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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, Trevisani, Franco, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), 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, Trevisani, Franco, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
- Abstract
Background & Aims: The Barcelona Clinic Liver Cancer intermediate stage (BCLC-B) of hepatocellular carcinoma (HCC) includes extremely heterogeneous patients in terms of tumour 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 naïve 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<.0001). Independent prognosticators were gender and treatment. Curative treatments reduced mortality (HR 0.197, 95%CI: 0.098-0.395) more than TACE (HR 0.408, 95%CI: 0.211-0.789) (P<.0001) as compared with BSC. Propensity score matching confirmed the superiority of curative therapies over TACE. Conclusions: In everyday practice TACE represents the first-line therapy in an half of patients with naïve BCLC-B HCC since treatment choice is driven not only by liver function and nodule characteristics, but also by contraindications to procedures, comorbidities, age and patient opinion. The treatment type is an independent prognostic factor in BCLC-B patients and curative options offer the best outcome.
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- 2016
40. Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma
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Giannini, Edoardo G, primary, Moscatelli, Alessandro, additional, Pellegatta, Gaia, additional, Vitale, Alessandro, additional, Farinati, Fabio, additional, Ciccarese, Francesca, additional, Piscaglia, Fabio, additional, Rapaccini, Gian Lodovico, additional, Di Marco, Maria, additional, Caturelli, Eugenio, additional, Zoli, Marco, additional, Borzio, Franco, additional, Cabibbo, Giuseppe, additional, Felder, Martina, additional, Sacco, Rodolfo, additional, Morisco, Filomena, additional, Missale, Gabriele, additional, Foschi, Francesco Giuseppe, additional, Gasbarrini, Antonio, additional, Baroni, Gianluca Svegliati, additional, Virdone, Roberto, additional, Masotto, Alberto, additional, and Trevisani, Franco, additional
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- 2016
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41. Liver Transplantation in a Monolung Patient: A Strategy of Sequential Treatments of Multiple Lung Tuberculosis Ca-vitations and Hepatocellular Carcinoma on Hepatitis B Related Virus Cirrhosis
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Donataccio, Dino, primary, Bravo, Paola Del, additional, Masotto, Alberto, additional, Ceola, Marcello, additional, Calabrò, Francesco, additional, and Donataccio, Matteo, additional
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- 2011
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42. A Nomogram-Based Prognostic Model for Advanced Hepatocellular Carcinoma Patients Treated with Sorafenib: A Multicenter Study.
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Marasco, Giovanni, Poggioli, Francesco, Colecchia, Antonio, Cabibbo, Giuseppe, Pelizzaro, Filippo, Giannini, Edoardo Giovanni, Marinelli, Sara, Rapaccini, Gian Ludovico, Caturelli, Eugenio, Di Marco, Mariella, Biasini, Elisabetta, Marra, Fabio, Morisco, Filomena, Foschi, Francesco Giuseppe, Zoli, Marco, Gasbarrini, Antonio, Svegliati Baroni, Gianluca, Masotto, Alberto, Sacco, Rodolfo, and Raimondo, Giovanni
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RESEARCH ,LIVER function tests ,ALPHA fetoproteins ,PREDICTIVE tests ,HEMOGLOBINS ,FUNCTIONAL status ,MEDICAL cooperation ,HEALTH status indicators ,TREATMENT duration ,REGRESSION analysis ,SORAFENIB ,SURVIVAL analysis (Biometry) ,PLATELET count ,STATISTICAL models ,HEPATOCELLULAR carcinoma ,PROPORTIONAL hazards models ,BILIRUBIN ,ASPARTATE aminotransferase - Abstract
Simple Summary: Accurate prognostic systems capable of predicting the survival of patients with advanced hepatocellular carcinoma undergoing Sorafenib therapy are still lacking. The search for the ideal predictive tool for survival and drug response is justified by the recent availability of several other drugs effective for these patients, licensed as first- and second-line treatment, other than reducing adverse events and costs. In this study, we aimed to identify simple demographic and clinical parameters able to predict survival and Sorafenib response in a large multicenter cohort. In this study, we showed that patient's general status, liver function and damage laboratory parameters and HCC aggressiveness were associated with the outcome of Sorafenib therapy. Two predictive nomograms, helping clinicians in the therapeutic choice, were additionally created. Among scores and staging systems used for HCC, none showed a good prognostic ability in patients with advanced HCC treated with Sorafenib. We aimed to evaluate predictive factors of overall survival (OS) and drug response in HCC patients undergoing Sorafenib included in the Italian Liver Cancer (ITA.LI.CA.) multicenter cohort. Patients in the ITA.LI.CA database treated with Sorafenib and updated on 30 June 2019 were included. Demographic and clinical data before starting Sorafenib treatment were considered. For the evaluation of predictive factors for OS, a time-dependent Cox proportional hazard model was used. A total of 1107 patients were included in our analysis. The mean age was 64.3 years and 81.7% were male. Most patients were staged as BCLC B (205, 18.9%) or C (706, 65.1%). The median time of Sorafenib administration was 4 months (interquartile range (IQR) 2–12), and the median OS was 10 months (IQR: 4–20). A total of 263 patients (33.8%) out of 780 with available evaluation experienced objective tumoral response to Sorafenib. The Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) (hazard ratio (HR) 1.284), maximum tumoral diameter (HR 1.100), plasma total bilirubin (HR 1.119), aspartate amino transferase assessed as multiple of the upper normal value (HR 1.032), alpha-fetoprotein ≥200 ng/mL (HR 1.342), hemoglobin (HR 0.903) and platelet count (HR 1.002) were associated with OS at multivariate Cox regression analysis. Drug response was predicted by maximum tumoral diameter and platelet count. A novel prognostic nomogram for patients undergoing Sorafenib is hereby proposed. The novelty introduced is the comprehensive patient's assessment using common markers of patient's general status, liver damage and function and HCC biology. Further studies are required to test its accuracy and provide external validation. [ABSTRACT FROM AUTHOR]
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- 2021
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43. Potential feasibility of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma treated with tyrosine-kinase inhibitors
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Benedetta Stefanini, Laura Bucci, Valentina Santi, Nicola Reggidori, Davide Rampoldi, Lorenzo Lani, Alessandro Granito, Angelo Sangiovanni, Giuseppe Cabibbo, Fabio Farinati, Claudia Campani, Francesco Giuseppe Foschi, Gianluca Svegliati-Baroni, Giovanni Raimondo, Antonio Gasbarrini, Andrea Mega, Elisabetta Biasini, Rodolfo Sacco, Filomena Morisco, Eugenio Caturelli, Gianpaolo Vidili, Francesco Azzaroli, Edoardo G. Giannini, Gian Ludovico Rapaccini, Maurizia Rossana Brunetto, Alberto Masotto, Gerardo Nardone, Mariella Di Marco, Donatella Magalotti, Franco Trevisani, Maurizio Biselli, Paolo Caraceni, Annagiulia Gramenzi, Francesco Tovoli, Luca Muratori, Francesca Benevento, Gloria Allegrini, Calogero Cammà, Ciro Celsa, Paolo Giuffrida, Caterina Stornello, Mauro Grova, Carmelo Marco Giacchetto, Gabriele Rancatore, Maria Vittoria Grassini, Valentina Adotti, Stefano Gitto, Fabio Marra, Martina Rosi, Vittoria Bevilacqua, Alberto Borghi, Andrea Casadei Gardini, Fabio Conti, Anna Chiara Dall'Aglio, Giorgio Ercolani, Federica Mirici, Nicoletta de Matthaeis, Francesca Romana Ponziani, Gabriele Missale, Andrea Olivani, Maria Guarino, Valentina Cossiga, Mario Capasso, Ester Marina Cela, Antonio Facciorusso, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Fabrizio Chegai, Fabio Coratella, Mariano Ortenzi, Serena Dell'Isola, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Elton Dajti, Federico Ravaioli, Giulia Pieri, Maria Corina Plaz Torres, Filippo Oliveri, Gabriele Ricco, Veronica Romagnoli, Alessandro Inno, Fabiana Marchetti, Pietro Coccoli, Antonio Malerba, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, null Matteo Renzulli, Stefanini, B., Bucci, L., Santi, V., Reggidori, N., Rampoldi, D., Lani, L., Granito, A., Sangiovanni, A., Cabibbo, G., Farinati, F., Campani, C., Foschi, F. G., Svegliati-Baroni, G., Raimondo, G., Gasbarrini, A., Mega, A., Biasini, E., Sacco, R., Morisco, F., Caturelli, E., Vidili, G., Azzaroli, F., Giannini, E. G., Rapaccini, G. L., Brunetto, M. R., Masotto, A., Nardone, G., Di Marco, M., Magalotti, D., Trevisani, F., Biselli, M., Caraceni, P., Gramenzi, A., Tovoli, F., Muratori, L., Benevento, F., Allegrini, G., Camma, C., Celsa, C., Giuffrida, P., Stornello, C., Grova, M., Giacchetto, C. M., Rancatore, G., Grassini, M. V., Adotti, V., Gitto, S., Marra, F., Rosi, M., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Dall'Aglio, A. C., Ercolani, G., Mirici, F., de Matthaeis, N., Ponziani, F. R., Missale, G., Olivani, A., Guarino, M., Cossiga, V., Capasso, M., Cela, E. M., Facciorusso, A., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Dell'Isola, S., Franze, M. S., Saitta, C., Sauchella, A., Dajti, E., Ravaioli, F., Pieri, G., Torres, M. C. P., Oliveri, F., Ricco, G., Romagnoli, V., Inno, A., Marchetti, F., Coccoli, P., Malerba, A., Cappelli, A., Golfieri, R., Mosconi, C., Matteo, Renzulli, Stefanini, Benedetta, Bucci, Laura, Santi, Valentina, Reggidori, Nicola, Rampoldi, Davide, Lani, Lorenzo, Granito, Alessandro, Sangiovanni, Angelo, Cabibbo, Giuseppe, Farinati, Fabio, Campani, Claudia, Foschi, Francesco Giuseppe, Svegliati-Baroni, Gianluca, Raimondo, Giovanni, Gasbarrini, Antonio, Mega, Andrea, Biasini, Elisabetta, Sacco, Rodolfo, Morisco, Filomena, Caturelli, Eugenio, Vidili, Gianpaolo, Azzaroli, Francesco, Giannini, Edoardo G, Rapaccini, Gian Ludovico, Brunetto, Maurizia Rossana, Masotto, Alberto, Nardone, Gerardo, Di Marco, Mariella, Magalotti, Donatella, and Trevisani, Franco
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Atezolizumab-bevacizumab ,Clinical Trials as Topic ,Antineoplastic Combined Chemotherapy Protocol ,Carcinoma, Hepatocellular ,Systemic therapy ,Hepatology ,Hepatocellular carcinoma ,Tirosin-kinase inhibitor ,Liver Neoplasms ,Gastroenterology ,Bevacizumab ,Feasibility Studie ,Tyrosine ,Human - Abstract
Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, be-coming the standard of care of systemic therapy.Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors.Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients.Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features.Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the reg-istration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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- 2022
44. Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma
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Edoardo G. Giannini, Giulia Pieri, Sara Labanca, Maria Corina Plaz Torres, Antonio Gasbarrini, Elisabetta Biasini, Claudia Campani, Nora Cazzagon, Francesco Giuseppe Foschi, Andrea Mega, Alberto Masotto, Giovanni Raimondo, Gian Ludovico Rapaccini, Rodolfo Sacco, Eugenio Caturelli, Maria Guarino, Francesco Tovoli, Gianpaolo Vidili, Maurizia Rossana Brunetto, Gerardo Nardone, Gianluca Svegliati-Baroni, Donatella Magalotti, Francesco Azzaroli, Giuseppe Cabibbo, Maria Di Marco, Angelo Sangiovanni, Franco Trevisani, Maurizio Biselli, Paolo Caraceni, Annagiulia Gramenzi, Francesca Benevento, Alessandro Granito, Luca Muratori, Fabio Piscaglia, Federica Bertellini, Fabio Farinati, Giorgio Palano, Filippo Pelizzaro, Barbara Penzo, Elisa Pinto, Gloria Allegrini, Calogero Cammà, Ciro Celsa, Paolo Giuffrida, Caterina Stornello, Mauro Grova, Carmelo Marco Giacchetto, Gabriele Rancatore, Maria Vittoria Grassini, Valentina Adotti, Stefano Gitto, Fabio Marra, Martina Rosi, Vittoria Bevilacqua, Alberto Borghi, Andrea Casadei Gardini, Fabio Conti, Lucia Napoli, Marco Domenicali, Maria Teresa Migliano, Nicoletta de Matthaeis, Francesca Romana Ponziani, Andrea Olivani, Gabriele Missale, Valentina Cossiga, Mario Capasso, Filomena Morisco, Ester Marina Cela, Antonio Facciorusso, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Fabrizio Chegai, Fabio Coratella, Mariano Ortenzi, Serena Dell'Isola, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Elton Dajti, Federico Ravaioli, Filippo Oliveri, Gabriele Ricco, Veronica Romagnoli, Alessandro Inno, Fabiana Marchetti, Pietro Coccoli, Antonio Malerba, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Giannini, Edoardo G, Pieri, Giulia, Labanca, Sara, Plaz Torres, Maria Corina, Gasbarrini, Antonio, Biasini, Elisabetta, Campani, Claudia, Cazzagon, Nora, Foschi, Francesco Giuseppe, Mega, Andrea, Masotto, Alberto, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Sacco, Rodolfo, Caturelli, Eugenio, Guarino, Maria, Tovoli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Svegliati-Baroni, Gianluca, Magalotti, Donatella, Azzaroli, Francesco, Cabibbo, Giuseppe, Di Marco, Maria, Sangiovanni, Angelo, Trevisani, Franco, Giannini, E. G., Pieri, G., Labanca, S., Plaz Torres, M. C., Gasbarrini, A., Biasini, E., Campani, C., Cazzagon, N., Foschi, F. G., Mega, A., Masotto, A., Raimondo, G., Rapaccini, G. L., Sacco, R., Caturelli, E., Guarino, M., Tovoli, F., Vidili, G., Brunetto, M. R., Nardone, G., Svegliati-Baroni, G., Magalotti, D., Azzaroli, F., Cabibbo, G., Di Marco, M., Sangiovanni, A., Trevisani, F., Biselli, M., Caraceni, P., Gramenzi, A., Benevento, F., Granito, A., Muratori, L., Piscaglia, F., Bertellini, F., Farinati, F., Palano, G., Pelizzaro, F., Penzo, B., Pinto, E., Allegrini, G., Camma, C., Celsa, C., Giuffrida, P., Stornello, C., Grova, M., Giacchetto, C. M., Rancatore, G., Grassini, M. V., Adotti, V., Gitto, S., Marra, F., Rosi, M., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Napoli, L., Domenicali, M., Migliano, M. T., de Matthaeis, N., Ponziani, F. R., Olivani, A., Missale, G., Cossiga, V., Capasso, M., Morisco, F., Cela, E. M., Facciorusso, A., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Dell'Isola, S., Franze, M. S., Saitta, C., Sauchella, A., Dajti, E., Ravaioli, F., Oliveri, F., Ricco, G., Romagnoli, V., Inno, A., Marchetti, F., Coccoli, P., Malerba, A., Cappelli, A., Golfieri, R., Mosconi, C., and Renzulli, M.
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Male ,Carcinoma, Hepatocellular ,Cholestatic liver disease ,Outcome ,Surveillance ,Survival ,Treatment ,Hepatology ,Prognosi ,Liver Cirrhosis, Biliary ,Risk Factor ,Settore MED/12 - GASTROENTEROLOGIA ,Liver Neoplasms ,Gastroenterology ,Prognosis ,Risk Factors ,Humans ,Female ,Human ,Aged - Abstract
Background: Comprehensive and contemporary data pertaining large populations of patients with Primary Biliary Cholangitis (PBC) and hepatocellular carcinoma (HCC) are missing. Aim: To describe main characteristics and outcome of PBC patients with HCC diagnosed in the new millennium. Methods: Analysing the Italian Liver Cancer registry we identified 80 PBC patients with HCC diagnosed after the year 2000, and described their clinical characteristics, access to treatment and survival. Results: Median age of patients was 71 years and 50.0% were males. Cirrhosis was present in 86.3% of patients, being well-compensated in 58.0%. Median HCC diameter was smaller in patients under surveillance (2.6vs 4.0cm, P=0.007). Curative treatment, feasible in 50.0% of patients, was associated with improved survival compared to palliative and supportive care (42vs 33vs 6 months, P
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- 2022
45. Surveillance for hepatocellular carcinoma with a 3-months interval in 'extremely high-risk' patients does not further improve survival
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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
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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.
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- 2022
46. Transarterial Chemoembolization for Hepatocellular Carcinoma in Clinical Practice: Temporal Trends and Survival Outcomes of an Iterative Treatment
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Filippo Pelizzaro, Selion Haxhi, Barbara Penzo, Alessandro Vitale, Edoardo G. Giannini, Vito Sansone, Gian Ludovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Donatella Magalotti, Rodolfo Sacco, Ciro Celsa, Claudia Campani, Andrea Mega, Maria Guarino, Antonio Gasbarrini, Gianluca Svegliati-Baroni, Francesco Giuseppe Foschi, Andrea Olivani, Alberto Masotto, Gerardo Nardone, Giovanni Raimondo, Francesco Azzaroli, Gianpaolo Vidili, Maurizia Rossana Brunetto, Franco Trevisani, Fabio Farinati, Pelizzaro F., Haxhi S., Penzo B., Vitale A., Giannini E.G., Sansone V., Rapaccini G.L., Di Marco M., Caturelli E., Magalotti D., Sacco R., Celsa C., Campani C., Mega A., Guarino M., Gasbarrini A., Svegliati-Baroni G., Foschi F.G., Olivani A., Masotto A., Nardone G., Raimondo G., Azzaroli F., Vidili G., Brunetto M.R., Trevisani F., Farinati F., Pelizzaro, F., Haxhi, S., Penzo, B., Vitale, A., Giannini, E. G., Sansone, V., Rapaccini, G. L., Di Marco, M., Caturelli, E., Magalotti, D., Sacco, R., Celsa, C., Campani, C., Mega, A., Guarino, M., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Olivani, A., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Brunetto, M. R., Trevisani, F., Farinati, F., Pelizzaro, Filippo, Haxhi, Selion, Penzo, Barbara, Vitale, Alessandro, Giannini, Edoardo G, Sansone, Vito, Rapaccini, Gian Ludovico, Di Marco, Maria, Caturelli, Eugenio, Magalotti, Donatella, Sacco, Rodolfo, Celsa, Ciro, Campani, Claudia, Mega, Andrea, Guarino, Maria, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Trevisani, Franco, and Farinati, Fabio
- Subjects
Cancer Research ,Oncology ,Settore MED/09 - MEDICINA INTERNA ,iterative treatment ,hepatocellular carcinoma ,survival ,therapeutic hierarchy ,transarterial chemoembolization ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundTransarterial chemoembolization (TACE) is one of the most frequently applied treatments for hepatocellular carcinoma (HCC) worldwide. In this study, we aimed at evaluating whether and how TACE application and repetition, as well as the related outcome, have changed over the last three decades in Italy.MethodsData of 7,184 patients with HCC were retrieved from the Italian Liver Cancer (ITA.LI.CA) database. Patients were divided according to the period of diagnosis in six cohorts: P1 (1988–1993), P2 (1994–1998), P3 (1999–2004), P4 (2005–2009), P5 (2010–2014), and P6 (2015–2019). All the analyses were repeated in the overall patient population and in Barcelona Clinic Liver Cancer (BCLC) B patients, who are the subgroup of HCC patients originally supposed to receive TACE according to guidelines. TACE was defined as either the first or the main (more effective) treatment.ResultsThe proportion of patients receiving TACE as first or main therapy declined over time, and less than 50% of BCLC B patients were treated with chemoembolization from P3 onward. Conversely, TACE was widely used even outside the intermediate stage. Survival of TACE-treated patients progressively increased from P1 to P6. Although TACE was performed only once in the majority of patients, there was an increasing proportion of those receiving 2 or ≥3 treatments sessions over time. The overall survival (OS) of patients undergoing repeated treatments was significantly higher compared to those managed with a single TACE (median OS 40.0 vs. 65.0 vs. 71.8 months in 1, 2, and ≥3 TACE groups, respectively; p < 0.0001). However, after a first-line TACE, the adoption of curative therapies provided longer survival than repeating TACE (83.0 vs. 42.0 months; p < 0.0001), which in turn was associated with better outcomes compared to systemic therapies or best supportive care (BSC).ConclusionsDespite a decline in the percentage of treated patients over time, TACE has still an important role in the management of HCC patients. The survival of TACE-treated patients gradually improved over time, probably due to a better patient selection. Iterative TACE is effective, but an upward shift to curative therapies provides better outcomes while transition to systemic therapies and BSC leads to a worse prognosis.
- Published
- 2022
47. Epidemiological trends and trajectories of MAFLD-associated hepatocellular carcinoma 2002-2033: The ITA.LI.CA database
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Alessandro, Vitale, Gianluca, Svegliati-Baroni, Alessio, Ortolani, Monica, Cucco, Giulio V, Dalla Riva, Edoardo G, Giannini, Fabio, Piscaglia, Gianludovico, Rapaccini, Mariella, Di Marco, Eugenio, Caturelli, Marco, Zoli, Rodolfo, Sacco, Giuseppe, Cabibbo, Fabio, Marra, Andrea, Mega, Filomena, Morisco, Antonio, Gasbarrini, Francesco Giuseppe, Foschi, Gabriele, Missale, Alberto, Masotto, Gerardo, Nardone, Giovanni, Raimondo, Francesco, Azzaroli, Gianpaolo, Vidili, Filippo, Oliveri, Filippo, Pelizzaro, Rafael, Ramirez Morales, Umberto, Cillo, Franco, Trevisani, Luca, Miele, Giulio, Marchesini, Fabio, Farinati, Alessandro, Di Bucchianico, Vitale, A., Svegliati-Baroni, G., Ortolani, A., Cucco, M., Dalla Riva, G. V., Giannini, E. G., Piscaglia, F., Rapaccini, G., Di Marco, M., Caturelli, E., Zoli, M., Sacco, R., Cabibbo, G., Marra, F., Mega, A., Morisco, F., Gasbarrini, A., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Pelizzaro, F., Ramirez Morales, R., Cillo, U., Trevisani, F., Miele, L., Marchesini, G., Farinati, F., Alessandro Vitale, Gianluca Svegliati-Baroni, Alessio Ortolani, Monica Cucco, Giulio V Dalla Riva, Edoardo G Giannini, Fabio Piscaglia, Gianludovico Rapaccini, Mariella Di Marco, Eugenio Caturelli, Marco Zoli, Rodolfo Sacco, Giuseppe Cabibbo, Fabio Marra, Andrea Mega, Filomena Morisco, Antonio Gasbarrini, Francesco Giuseppe Foschi, Gabriele Missale, Alberto Masotto, Gerardo Nardone, Giovanni Raimondo, Francesco Azzaroli, Gianpaolo Vidili, Filippo Oliveri, Filippo Pelizzaro, Rafael Ramirez Morales, Umberto Cillo, Franco Trevisani, Luca Miele, Giulio Marchesini, Fabio Farinati, Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Dalla Riva, Giulio V, Giannini, Edoardo G, Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Pelizzaro, Filippo, Ramirez Morales, Rafael, Cillo, Umberto, Trevisani, Franco, Miele, Luca, Marchesini, Giulio, and Farinati, Fabio
- Subjects
Male ,Settore MED/12 - Gastroenterologia ,Carcinoma, Hepatocellular ,Liver Neoplasms ,nonalcoholic steatohepatitis ,Gastroenterology ,hepatocellular carcinoma ,digestive system diseases ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Humans ,neoplasms - Abstract
BackgroundMetabolic dysfunction-associated fatty liver disease (MAFLD) represents a new inclusive definition of the whole spectrum of liver diseases associated to metabolic disorders. The main objective of this study was to compare patients with MAFLD and non-MAFLD with hepatocellular carcinoma (HCC) included in a nationally representative cohort.MethodsWe analysed 6882 consecutive patients with HCC enrolled from 2002 to 2019 by 23 Italian Liver Cancer centres to compare epidemiological and future trends in three subgroups: pure, single aetiology MAFLD (S-MAFLD); mixed aetiology MAFLD (metabolic and others, M-MAFLD); and non-MAFLD HCC.ResultsMAFLD was diagnosed in the majority of patients with HCC (68.4%). The proportion of both total MAFLD and S-MAFLD HCC significantly increased over time (from 50.4% and 3.6% in 2002–2003, to 77.3% and 28.9% in 2018–2019, respectively, pConclusionsThe prevalence of MAFLD HCC in Italy is rapidly increasing to cover the majority of patients with HCC. Despite a less favourable cancer stage at diagnosis, patients with MAFLD HCC have a lower risk of HCC-related death, suggesting reduced cancer aggressiveness.
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- 2021
48. Plasma cholesterol and lipoprotein levels in relation to tumor aggressiveness and survival in HCC patients
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Fabio Farinati, Brian I. Carr, Roberto Virdone, Gianluigi Giannelli, Alberto Masotto, Gian Ludovico Rapaccini, Franco Trevisani, Vito Guerra, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Rodolfo Sacco, Edoardo G. Giannini, Carr, Brian I., Giannelli, Gianluigi, Guerra, Vito, Giannini, Edoardo G, Farinati, Fabio, Rapaccini, Gian Ludovico, Di Marco, Maria, Zoli, Marco, Caturelli, Eugenio, Masotto, Alberto, Virdone, Roberto, Sacco, Rodolfo, and Trevisani, Franco
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Adult ,Male ,medicine.medical_specialty ,Cancer Research ,Carcinoma, Hepatocellular ,Survival ,Hepatocellular carcinoma ,Hepatitis C virus ,Lipoproteins ,Clinical Biochemistry ,aggressiveness ,lipids ,survival ,medicine.disease_cause ,Gastroenterology ,Virus ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Aggressivene ,Plasma cholesterol ,Chronic hepatitis ,Internal medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Aged ,Retrospective Studies ,business.industry ,Liver Neoplasms ,Lipid ,Middle Aged ,medicine.disease ,Hepatitis C ,Cholesterol ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,lipids (amino acids, peptides, and proteins) ,Female ,alpha-Fetoproteins ,business ,Lipoprotein - Abstract
Background and Aims:Hepatocellular carcinoma is associated with several chronic liver diseases, especially chronic hepatitis B virus, hepatitis C virus, and alcoholism. It is increasingly appreciated that obesity/metabolic syndrome is also associated with chronic liver disease and subsequent hepatocellular carcinoma.Methods:We retrospectively investigated the serum lipid profiles in a large hepatocellular carcinoma cohort, associated predominantly with the hepatitis B virus, hepatitis C virus, alcohol or nonalcoholic steatohepatitis. The cohort was examined both as a whole, as well as stratified by etiology.Results:We found significant associations between parameters of hepatocellular carcinoma biology such as maximum tumor diameter, portal vein thrombosis, tumor multifocality or alpha-fetoprotein levels and individual lipid components, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and body mass index. In a final multiple linear regression model considering all lipid variables together, only high-density lipoprotein cholesterol was significantly associated with the tumor Tumor Aggressiveness Index. High-density lipoprotein cholesterol was found to have a statistically higher hazard ratio for death than low high-density lipoprotein cholesterol levels (Cox). On examination by etiological group, alpha-fetoprotein levels were significantly higher in patients with hepatitis C virus compared to those with alcohol or nonalcoholic steatohepatitis, but maximum tumor diameter, tumor multifocality and portal vein thrombosis were similar across etiological groups. Nonalcoholic steatohepatitis patients had significantly less cirrhosis than other groups and hepatitis B virus patients had significantly higher cholesterol and low-density lipoprotein cholesterol levels than hepatitis C virus patients.Conclusions:This is the first report, to our knowledge, of a relationship between serum lipid parameters and indices of hepatocellular carcinoma growth, invasion and aggressiveness, as well as with survival.
- Published
- 2018
49. Utility of Tumor Burden Score to Stratify Prognosis of Patients with Hepatocellular Cancer: Results of 4759 Cases from ITA.LI.CA Study Group
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Vitale, A, Lai, Q, Farinati, F, Bucci, L, Giannini, Eg, Napoli, L, Ciccarese, F, Rapaccini, Gl, Di Marco, M, Caturelli, E, Zoli, M, Borzio, F, Sacco, R, Cabibbo, G, Virdone, R, Marra, F, Felder, M, Morisco, F, Benvegnù, L, Gasbarrini, A, Svegliati-Baroni, G, Foschi, Fg, Missale, G, Masotto, A, Nardone, G, Colecchia, A, Bernardi, M, Trevisani, F, Pawlik, Tm, Italian Liver Cancer, (ITA. LI. CA) group., Vitale, Alessandro, Lai, Quirino, Farinati, Fabio, Bucci, Laura, Giannini, Edoardo G., Napoli, Lucia, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, 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, Pawlik, Timothy M., and D'Alessandro, Vitale
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Oncology ,Male ,Hepatocellular carcinoma ,Tumor burden ,Disease ,Severity of Illness Index ,Milan Criteria ,Outcomes ,Prognosis ,0302 clinical medicine ,Risk Factors ,Outcome ,education.field_of_study ,Liver Neoplasms ,Gastroenterology ,Middle Aged ,Survival Rate ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,alpha-Fetoproteins ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Prognosi ,Settore MED/12 - GASTROENTEROLOGIA ,Population ,Milan criteria ,End Stage Liver Disease ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Neoplasm Invasiveness ,Risk factor ,education ,Survival analysis ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Hepatocellular carcinoma, Milan Criteria, Outcomes, Prognosis, Tumor burden, Surgery, Gastroenterology ,business.industry ,Proportional hazards model ,medicine.disease ,Blood Vessels ,Surgery ,business - Abstract
Background: Dichotomous models like Milan Criteria represent the routinely used tools for predicting the outcome of patients with hepatocellular carcinoma (HCC). However, a paradigm shift from a dichotomous to continuous prognostic stratification should represent a good strategy for improving the prediction process. Recently, the tumor burden score (TBS) has been proposed for selecting patients with colorectal liver metastases. To date, TBS has not been validated in a large HCC population. The main objective of this study was to evaluate the prognostic power of TBS in an HCC population treated with different curative and palliative modalities. Methods: Prospectively collected data from consecutive HCC patients managed in 24 institutions participating in the ITA.LI.CA group between Jan 2002 and Mar 2015 were analyzed (n = 4759). A sub-analysis focused on 3909 patients with the radiological evidence of vascular invasion or metastatic disease was also performed. Results: TBS demonstrated the best discriminative ability when compared to MC and other tumor-specific scores. At multivariable Cox regression analysis, TBS was an independent risk factor of overall survival, with a 6% increased risk for patient death for each point increase in TBS. At survival analysis, when TBS ≥ 8 was connected with MELD ≥ 15 and alpha-fetoprotein ≥ 1000 ng/mL, patients presenting all these three risk factors presented the worst results (p value < 0.0001). Conclusions: Survival prediction of HCC patients was very well done using TBS model, even stratifying the population in relation to the presence of metastases and/or vascular invasion. TBS model was the best in terms of discriminatory ability and goodness of fit when compared with other continuous or binary variables. Its incorporation in a model composed by tumor- and liver function-related variables further increases its survival prediction.
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- 2018
50. Restaging Patients With Hepatocellular Carcinoma Before Additional Treatment Decisions: A Multicenter Cohort Study
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Vitale, A, Farinati, F, Noaro, G, Burra, P, Pawlik, Tm, Bucci, L, Giannini, Eg, Faggiano, C, Ciccarese, F, Rapaccini, Gl, Di Marco, M, Caturelli, E, Zoli, M, Borzio, F, Sacco, R, Cabibbo, G, Virdone, R, Marra, F, Felder, M, Morisco, F, Benvegnù, L, Gasbarrini, A, Svegliati-Baroni, G, Foschi, Fg, Olivani, A, Masotto, A, Nardone, G, Colecchia, A, Fornari, F, Marignani, M, Vicari, S, Bortolini, E, Cozzolongo, R, Grasso, A, Aliberti, C, Bernardi, M, Frigo, Ac, Borzio, M, Trevisani, F, Cillo, U, CA) group, Italian Liver Cancer (ITA. LI., Vitale, Alessandro, Farinati, Fabio, Noaro, Giulia, Burra, Patrizia, Pawlik, Timothy M., Bucci, Laura, Giannini, Edoardo G., Faggiano, Chiara, Ciccarese, Francesca, Rapaccini, Gian Lodovico, Di Marco, Maria, Caturelli, Eugenio, Zoli, Marco, Borzio, Franco, Sacco, Rodolfo, Cabibbo, Giuseppe, Virdone, Roberto, Marra, Fabio, Felder, Martina, Morisco, Filomena, Benvegnù, Luisa, Gasbarrini, Antonio, Svegliati-Baroni, Gianluca, Foschi, Francesco Giuseppe, Olivani, Andrea, Masotto, Alberto, Nardone, Gerardo, Colecchia, Antonio, Fornari, Fabio, Marignani, Massimo, Vicari, Susanna, Bortolini, Emanuela, Cozzolongo, Raffaele, Grasso, Alessandro, Aliberti, Camillo, Bernardi, Mauro, Frigo, Anna Chiara, Borzio, Mauro, Trevisani, Franco, and Cillo, Umberto
- Subjects
Male ,Oncology ,Databases, Factual ,Liver cancer ,non surgical therapy ,prognostic system ,surgical therapy ,survival ,hepatocellular carcinoma, stage, treatment ,Kaplan-Meier Estimate ,Cohort Studies ,Liver disease ,0302 clinical medicine ,Middle Aged ,Sorafenib ,Prognosis ,Italy ,030220 oncology & carcinogenesis ,Catheter Ablation ,Disease Progression ,Female ,030211 gastroenterology & hepatology ,medicine.drug ,Cohort study ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Settore MED/12 - GASTROENTEROLOGIA ,Clinical Decision-Making ,Risk Assessment ,Disease-Free Survival ,Statistics, Nonparametric ,03 medical and health sciences ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Infusions, Intra-Arterial ,Neoplasm Invasiveness ,Survival analysis ,Aged ,Neoplasm Staging ,Retrospective Studies ,Analysis of Variance ,Hepatology ,business.industry ,Reproducibility of Results ,Cancer ,Retrospective cohort study ,medicine.disease ,Survival Analysis ,business ,Progressive disease - Abstract
Prognostic assessment of patients with hepatocellular carcinoma (HCC) at the time of diagnosis remains controversial and becomes even more complex at the time of restaging when new variables need to be considered. The aim of the current study was to evaluate the prognostic utility of restaging patients before proceeding with additional therapies for HCC. Two independent Italian prospective databases were used to identify 1,196 (training cohort) and 648 (validation cohort) consecutive patients with HCC treated over the same study period (2008-2015) who had complete restaging before decisions about additional therapies. The performance of the Italian Liver Cancer (ITA.LI.CA) prognostic score at restaging was compared with that of the Barcelona Clinic Liver Cancer, Hong Kong Liver Cancer, and Cancer of the Liver Italian Program systems. A multivariable Cox survival analysis was performed to identify baseline, restaging, or dynamic variables that were able to improve the predictive performance of the prognostic systems. At restaging, 35.3% of patients maintained stable disease; most patients were either down-staged by treatment (27.2%) or had disease progression (37.5%). The ITA.LI.CA scoring system at restaging demonstrated the best prognostic performance in both the training and validation cohorts (c-index 0.707 and 0.722, respectively) among all systems examined. On multivariable analysis, several variables improved the prognostic ability of the ITA.LI.CA score at restaging, including progressive disease after the first treatment, Model for End-Stage Liver Disease at restaging, and choice of nonsurgical treatment as additional therapy. A new ITA.LI.CA restaging model was created that demonstrated high discriminative power in both the training and validation cohorts (c-index 0.753 and 0.745, respectively). Conclusion: Although the ITA.LI.CA score demonstrated the best prognostic performance at restaging, other variables should be considered to improve the prognostic assessment of patients at the time of deciding additional therapies for HCC.
- Published
- 2018
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