Brian I Carr1, Vito Guerra. 1. Departments of aHCC Biology bEpidemiology, IRCCS S. de Bellis, National Institute for Digestive Diseases, Castellana Grotte (BA), Italy.
Abstract
BACKGROUND: Massive hepatocellular carcinomas (HCCs) are uncommon and poorly characterized. AIM: To characterize a large cohort of HCC patients with massive tumors, with documented baseline characteristics and survival data. METHODS: Records were examined of a cohort of 344 biopsy-proven and randomly presenting unresectable HCC patients with tumors of at least 10 cm diameter (massive), which were analyzed for their clinical characteristics and survival. RESULTS: Massive HCC patients were significantly different from others, in having less severe cirrhosis and higher blood platelet counts, α-fetoprotein (AFP), alkaline phosphatase (ALKP), and γ-glutamyl transpeptidase (GGTP) levels. Platelets, ALKP, and GGTP correlated with tumor size. Within massive HCCs, ALKP levels related to tumor number, whereas platelet counts related to tumor size. AFP and GGTP related to neither. All four parameters related to survival. A multivariate Cox proportional hazard model showed that ALKP and AFP were significant for overall survival. Survival of massive tumors was not significantly worse than for other larger tumors. CONCLUSION: Massive HCCs were characterized by high blood platelets, AFP, ALKP, and GGTP levels. AFP levels were important for survival, but did not directly relate to tumor size or number, suggesting that AFP represents some other property of massive HCC biology. Patients with massive HCC should thus be considered for active therapeutic intervention, just as for other sizes of HCC.
BACKGROUND: Massive hepatocellular carcinomas (HCCs) are uncommon and poorly characterized. AIM: To characterize a large cohort of HCC patients with massive tumors, with documented baseline characteristics and survival data. METHODS: Records were examined of a cohort of 344 biopsy-proven and randomly presenting unresectable HCC patients with tumors of at least 10 cm diameter (massive), which were analyzed for their clinical characteristics and survival. RESULTS: Massive HCC patients were significantly different from others, in having less severe cirrhosis and higher blood platelet counts, α-fetoprotein (AFP), alkaline phosphatase (ALKP), and γ-glutamyl transpeptidase (GGTP) levels. Platelets, ALKP, and GGTP correlated with tumor size. Within massive HCCs, ALKP levels related to tumor number, whereas platelet counts related to tumor size. AFP and GGTP related to neither. All four parameters related to survival. A multivariate Cox proportional hazard model showed that ALKP and AFP were significant for overall survival. Survival of massive tumors was not significantly worse than for other larger tumors. CONCLUSION: Massive HCCs were characterized by high blood platelets, AFP, ALKP, and GGTP levels. AFP levels were important for survival, but did not directly relate to tumor size or number, suggesting that AFP represents some other property of massive HCC biology. Patients with massive HCC should thus be considered for active therapeutic intervention, just as for other sizes of HCC.
Authors: Brian I Carr; Vito Guerra; Edoardo G Giannini; Fabio Farinati; Francesca Ciccarese; Gian Ludovico Rapaccini; Maria Di Marco; Luisa Benvegnù; Marco Zoli; Franco Borzio; Eugenio Caturelli; Maria Chiaramonte; Franco Trevisani Journal: Semin Oncol Date: 2014-03-06 Impact factor: 4.929
Authors: Brian I Carr; Vito Guerra; Rossella Donghia; Fabio Farinati; Edoardo G Giannini; Luca Muratori; Gian Ludovico Rapaccini; Maria Di Marco; Eugenio Caturelli; Marco Zoli; Rodolfo Sacco; Ciro Celsa; Claudia Campani; Andrea Mega; Maria Guarino; Antonio Gasbarrini; Gianluca Svegliati-Baroni; Francesco Giuseppe Foschi; Elisabetta Biasini; Alberto Masotto; Gerardo Nardone; Giovanni Raimondo; Francesco Azzaroli; Gianpaolo Vidili; Maurizia Rossana Brunetto; Franco Trevisani Journal: Cancers (Basel) Date: 2021-02-03 Impact factor: 6.639
Authors: Brian I Carr; Aldo Cavallini; Rosalba D'Alessandro; Maria Grazia Refolo; Catia Lippolis; Antonio Mazzocca; Caterina Messa Journal: BMC Cancer Date: 2014-01-27 Impact factor: 4.430