Giuseppe Cabibbo1, Salvatore Petta1, Marco Barbara1, Simona Attardo1, Laura Bucci2, Fabio Farinati3, Edoardo G Giannini4, Giulia Negrini5, Francesca Ciccarese6, Gian Lodovico Rapaccini7, Maria Di Marco8, Eugenio Caturelli9, Marco Zoli10, Franco Borzio11, Rodolfo Sacco12, Roberto Virdone13, Fabio Marra14, Andrea Mega15, Filomena Morisco16, Luisa Benvegnù17, Antonio Gasbarrini18, Gianluca Svegliati-Baroni19, Francesco Giuseppe Foschi20, Andrea Olivani21, Alberto Masotto22, Gerardo Nardone23, Antonio Colecchia2, Marcello Persico24, Antonio Craxì1, Franco Trevisani2, Calogero Cammà25. 1. Section of Gastroenterology, Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.), University of Palermo, Palermo, Italy. 2. Department of Medical and Surgical Sciences Semeiotica Medica, Alma Mater Studiorum-University of Bologna, Bologna, Italy. 3. Section of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy. 4. Gastroenterology Unit, Department Internal Medicine, University of Genoa, IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy. 5. Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. 6. Surgery Unit, Policlinico San Marco, Zingonia, Italy. 7. Division of Internal Medicine and Gastroenterology, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Rome, Italy. 8. Division of Medicine, Bolognini Hospital, Seriate, Italy. 9. Division of Gastroenterology, Belcolle Hospital, Viterbo, Italy. 10. Division of Radiology, Department of Medicine, Fatebenefratelli Hospital, Milan, Italy. 11. Division of Gastroenterology and Metabolic Diseases, University Hospital of Pisa, Pisa, Italy. 12. Division of Internal Medicine 2, Ospedali Riuniti Villa Sofia Cervello, Palermo, Italy. 13. Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Italy. 14. Division of Gastroenterology, Bolzano Regional Hospital, Bolzano, Italy. 15. Division of Gastroenterology, Department of Medicine and Surgery, University of Naples Federico II, Naples, Italy. 16. Departiment of Clinical and Experimental Medicine, Medical Unit, University of Padua, Italy. 17. Division of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy. 18. Division of Gastroenterology, Polytechnic University of Marche, Ancona, Italy. 19. Department of Internal Medicine, Ospedale per gli Infermi di Faenza, Faenza, Italy. 20. Division of Infectious Diseases and Hepatology, Parma University Hospital, Parma, Italy. 21. Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy. 22. Department of Clinical Medicine and Surgery, Hepatogastroenterology Unit, University Federico II, Naples, Italy. 23. Internal Medicine Unit, University of Salerno, Salerno, Italy. 24. Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy. 25. Section of Gastroenterology, Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.), University of Palermo, Palermo, Italy. Electronic address: calogero.camma@unipa.it.
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 12months 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): 1.23-13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23-5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02-2.70) and age (HR 1.04; 95% CI: 1.02-1.07) 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.
BACKGROUND & AIMS: Assessment of long-term outcome is required in hepatitis C virus (HCV)-infectedpatients 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 12months 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): 1.23-13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23-5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02-2.70) and age (HR 1.04; 95% CI: 1.02-1.07) were significantly associated with the 5-year OS. CONCLUSION: Survival in HCV-infectedpatients 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) infectedpatients 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.
Authors: Nicole E Rich; Ju Dong Yang; Ponni V Perumalswami; Naim Alkhouri; Whitney Jackson; Neehar D Parikh; Neil Mehta; Reena Salgia; Andres Duarte-Rojo; Laura Kulik; Mina Rakoski; Adnan Said; Omobonike Oloruntoba; George N Ioannou; Maarouf A Hoteit; Andrew M Moon; Amol S Rangnekar; Sheila L Eswaran; Elizabeth Zheng; Janice H Jou; James Hanje; Anjana Pillai; Ruben Hernaez; Robert Wong; Steven Scaglione; Hrishikesh Samant; Devika Kapuria; Shaun Chandna; Russell Rosenblatt; Veeral Ajmera; Catherine T Frenette; Sanjaya K Satapathy; Parvez Mantry; Prasun Jalal; Binu V John; Oren K Fix; Michael Leise; Christina C Lindenmeyer; Avegail Flores; Nayan Patel; Z Gordon Jiang; Nyan Latt; Renumathy Dhanasekaran; Mobolaji Odewole; Sofia Kagan; Jorge A Marrero; Amit G Singal Journal: Clin Gastroenterol Hepatol Date: 2019-07-26 Impact factor: 11.382
Authors: Harrys A Torres; Terri Lynn Shigle; Nassim Hammoudi; James T Link; Felipe Samaniego; Ahmed Kaseb; Vincent Mallet Journal: CA Cancer J Clin Date: 2017-07-06 Impact factor: 508.702
Authors: Giuseppe Cabibbo; Maria Reig; Ciro Celsa; Ferran Torres; Salvatore Battaglia; Marco Enea; Giacomo Emanuele Maria Rizzo; Salvatore Petta; Vincenza Calvaruso; Vito Di Marco; Antonio Craxì; Amit G Singal; Jordi Bruix; Calogero Cammà Journal: Liver Cancer Date: 2021-11-23 Impact factor: 11.740
Authors: Amit G Singal; Nicole E Rich; Neil Mehta; Andrea D Branch; Anjana Pillai; Maarouf Hoteit; Michael Volk; Mobolaji Odewole; Steven Scaglione; Jennifer Guy; Adnan Said; Jordan J Feld; Binu V John; Catherine Frenette; Parvez Mantry; Amol S Rangnekar; Omobonike Oloruntoba; Michael Leise; Janice H Jou; Kalyan Ram Bhamidimarri; Laura Kulik; George N Ioannou; Annsa Huang; Tram Tran; Hrishikesh Samant; Renumathy Dhanasekaran; Andres Duarte-Rojo; Reena Salgia; Sheila Eswaran; Prasun Jalal; Avegail Flores; Sanjaya K Satapathy; Sofia Kagan; Purva Gopal; Robert Wong; Neehar D Parikh; Caitlin C Murphy Journal: Gastroenterology Date: 2019-07-30 Impact factor: 22.682
Authors: Amit G Singal; Nicole E Rich; Neil Mehta; Andrea Branch; Anjana Pillai; Maarouf Hoteit; Michael Volk; Mobolaji Odewole; Steven Scaglione; Jennifer Guy; Adnan Said; Jordan J Feld; Binu V John; Catherine Frenette; Parvez Mantry; Amol S Rangnekar; Omobonike Oloruntoba; Michael Leise; Janice H Jou; Kalyan Ram Bhamidimarri; Laura Kulik; Tram Tran; Hrishikesh Samant; Renumathy Dhanasekaran; Andres Duarte-Rojo; Reena Salgia; Sheila Eswaran; Prasun Jalal; Avegail Flores; Sanjaya K Satapathy; Robert Wong; Annsa Huang; Suresh Misra; Myron Schwartz; Robert Mitrani; Sasank Nakka; Wassim Noureddine; Chanda Ho; Venkata R Konjeti; Alexander Dao; Kevin Nelson; Kelly Delarosa; Usman Rahim; Meher Mavuram; Jesse J Xie; Caitlin C Murphy; Neehar D Parikh Journal: Gastroenterology Date: 2019-01-18 Impact factor: 22.682