Laura Bucci1, Francesca Garuti1, Barbara Lenzi1, Anna Pecorelli2, Fabio Farinati3, Edoardo G Giannini4, Alessandro Granito2, Francesca Ciccarese5, Gian Lodovico Rapaccini6, Maria Di Marco7, Eugenio Caturelli8, Marco Zoli2, Franco Borzio9, Rodolfo Sacco10, Calogero Cammà11, Roberto Virdone12, Fabio Marra13, Martina Felder14, Filomena Morisco15, Luisa Benvegnù16, Antonio Gasbarrini17, Gianluca Svegliati-Baroni18, Francesco Giuseppe Foschi19, Gabriele Missale20, Alberto Masotto21, Gerardo Nardone22, Antonio Colecchia23, Mauro Bernardi1, Franco Trevisani1. 1. Unità di Semeiotica Medica, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum - Università di Bologna, Bologna, Italy. 2. Unità di Medicina Interna, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum - Università di Bologna, Bologna, Italy. 3. Unità di Gastroenterologia, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Università di Padova, Padova, Italy. 4. Unità di Gastroenterologia, Dipartimento di Medicina Interna, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Università di Genova, Genova, Italy. 5. Divisione di Chirurgia, Policlinico San Marco, Zingonia, Italy. 6. Unità di Medicina Interna e Gastroenterologia, Complesso Integrato Columbus, Università Cattolica di Roma, Rome, Italy. 7. Divisione di Medicina, Azienda Ospedaliera Bolognini, Seriate, Italy. 8. Unità Operativa di Gastroenterologia, Ospedale Belcolle, Viterbo, Italy. 9. Unità di Radiologia, Dipartimento di Medicina, Ospedale Fatebenefratelli, Milan, Italy. 10. Unità Operativa Gastroenterologia e Malattie del Ricambio, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. 11. Unità di Gastroenterologia, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy. 12. Divisione di Medicina Interna, Ospedale Villa Sofia - V. Cervello, Università di Palermo, Palermo, Italy. 13. Medicina Interna ed Epatologia, Dipartimento di Medicina Sperimentale e Clinica - Università di Firenze, Firenze, Italy. 14. Unità di Gastroenterologia, Ospedale Regionale di Bolzano, Bolzano, Italy. 15. Unità di Gastroenterologia, Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", Naples, Italy. 16. Dipartimento di Medicina Molecolare, Università di Padova, Padua, Italy. 17. Unità di Medicina Interna e Gastroenterologia, Policlinico Gemelli, Università Cattolica di Roma, Rome, Italy. 18. Dipartimento di Gastroenterologia, Gastroenterologia, Politecnico-Università delle Marche, Ancona, Italy. 19. Dipartimento di Medicina Interna, Ospedale per gli Infermi di Faenza, Faenza, Italy. 20. Unità di Malattie Infettive ed Epatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. 21. Unità di Gastroenterologia, Ospedale Sacro Cuore Don Calabria, Negrar, Italy. 22. Dipartimento di Medicina Clinica e Chirurgia, Unità di Epato-Gastroenterologia, Università di Napoli "Federico II", Naples, Italy. 23. Unità di Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum - Università di Bologna, Bologna, Italy.
Abstract
BACKGROUND & AIMS: Epidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of aetiology, presentation, management and prognosis of hepatocellular carcinoma in Italy during the last 15 years. METHODS: Retrospective analysis of the ITA.LI.CA (Italian Liver Cancer) database including 5192 hepatocellular carcinoma patients managed in 24 centres from 2000 to 2014. Patients were divided into three groups according to the date of cancer diagnosis (2000-2004, 2005-2009 and 2010-2014). RESULTS: The main results were as follows: (i) progressive patient aging; (ii) progressive expansion of non-viral cases and, namely, of "metabolic" hepatocellular carcinomas; (iii) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semi-annual) surveillance programme; (iv) favourable cancer stage migration; (v) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) improved overall survival (adjusted for the lead time in surveyed patients), particularly after 2009, of both viral and non-viral patients presenting with an early- or intermediate-stage hepatocellular carcinoma. CONCLUSIONS: During the last 15 years several aetiological and clinical features of hepatocellular carcinoma patients have changed, as their management. The observed improvement of overall survival was owing both to the wider use of semi-annual surveillance, expanding the proportion of tumours that qualified for curative treatments, and to the improved outcome of loco-regional treatments.
BACKGROUND & AIMS: Epidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of aetiology, presentation, management and prognosis of hepatocellular carcinoma in Italy during the last 15 years. METHODS: Retrospective analysis of the ITA.LI.CA (Italian Liver Cancer) database including 5192 hepatocellular carcinomapatients managed in 24 centres from 2000 to 2014. Patients were divided into three groups according to the date of cancer diagnosis (2000-2004, 2005-2009 and 2010-2014). RESULTS: The main results were as follows: (i) progressive patient aging; (ii) progressive expansion of non-viral cases and, namely, of "metabolic" hepatocellular carcinomas; (iii) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semi-annual) surveillance programme; (iv) favourable cancer stage migration; (v) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) improved overall survival (adjusted for the lead time in surveyed patients), particularly after 2009, of both viral and non-viral patients presenting with an early- or intermediate-stage hepatocellular carcinoma. CONCLUSIONS: During the last 15 years several aetiological and clinical features of hepatocellular carcinomapatients have changed, as their management. The observed improvement of overall survival was owing both to the wider use of semi-annual surveillance, expanding the proportion of tumours that qualified for curative treatments, and to the improved outcome of loco-regional treatments.
Authors: Melchiorre Cervello; Maria R Emma; Giuseppa Augello; Antonella Cusimano; Lydia Giannitrapani; Maurizio Soresi; Shaw M Akula; Stephen L Abrams; Linda S Steelman; Alessandro Gulino; Beatrice Belmonte; Giuseppe Montalto; James A McCubrey Journal: Aging (Albany NY) Date: 2020-02-04 Impact factor: 5.682