Luca Rinaldi1, Maria Guarino2, Alessandro Perrella3, Pia Clara Pafundi4, Giovanna Valente5, Luca Fontanella6, Riccardo Nevola4, Barbara Guerrera4, Natalina Iuliano4, Michele Imparato6, Alessio Trabucco4, Ferdinando Carlo Sasso4, Filomena Morisco2, Antonio Ascione6, Guido Piai5, Luigi Elio Adinolfi4. 1. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy. luca.rinaldi@unicampania.it. 2. Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy. 3. VII Department of Infectious Diseases and Immunology, Ospedali dei Colli P. O. D. Cotugno, Naples, Italy. 4. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Miraglia, 80138, Naples, Italy. 5. Department of Medical Sciences, A.O.R.N. S. Anna and S. Sebastiano, Caserta, Italy. 6. Department of Internal Medicine, Centre for Liver Disease, Buon Consiglio Fatebenefratelli Hospital, Naples, Italy.
Abstract
PURPOSE: The aim of this study was to evaluate the relationship between the liver stiffness measurement and the risk of developing hepatocellular carcinoma (HCC) in HCV cirrhotic patients undergoing new direct-acting antivirals. METHODS: From April 2015 to April 2017, all consecutive HCV cirrhotic patients treated by direct-acting antivirals were enrolled. A liver stiffness measurement was computed at baseline, and an ultrasound evaluation was provided for all patients at baseline and every 6 months until 1 year after the stopping of the antiviral therapy. The diagnosis of HCC was performed according to international guidelines by imaging technique workup. RESULTS: Two hundred and fifty-eight HCV patients with a diagnosis of cirrhosis were identified. The median liver stiffness was 25.5 kPa. Thirty-five patients developed HCC. Patients were divided into three groups, based on their liver stiffness: < 20 kPa (n = 72), between 20 and 30 kPa (n = 92) and > 30 kPa (n = 94). Compared to the < 20 kPa and 20-30 kPa groups, the > 30 kPa group showed a statistically significant increased risk of HCC (p = 0.019; HR 0.329; 95% CI 0.131-0.830). A ROC curve analysis to assess the overall predictive performance of liver stiffness measurement on the HCC risk was performed. The results allow us to identify a cutoff value of liver stiffness measurement equal to 27.8 kPa, which guarantees the highest sensitivity and specificity (respectively, 72% and 65%). CONCLUSIONS: The data underline that the baseline liver stiffness measurement and ultrasound surveillance is a valuable tool for assessing the risk of HCC in cirrhotic patients undergoing the direct-acting antivirals treatment.
PURPOSE: The aim of this study was to evaluate the relationship between the liver stiffness measurement and the risk of developing hepatocellular carcinoma (HCC) in HCV cirrhoticpatients undergoing new direct-acting antivirals. METHODS: From April 2015 to April 2017, all consecutive HCV cirrhoticpatients treated by direct-acting antivirals were enrolled. A liver stiffness measurement was computed at baseline, and an ultrasound evaluation was provided for all patients at baseline and every 6 months until 1 year after the stopping of the antiviral therapy. The diagnosis of HCC was performed according to international guidelines by imaging technique workup. RESULTS: Two hundred and fifty-eight HCV patients with a diagnosis of cirrhosis were identified. The median liver stiffness was 25.5 kPa. Thirty-five patients developed HCC. Patients were divided into three groups, based on their liver stiffness: < 20 kPa (n = 72), between 20 and 30 kPa (n = 92) and > 30 kPa (n = 94). Compared to the < 20 kPa and 20-30 kPa groups, the > 30 kPa group showed a statistically significant increased risk of HCC (p = 0.019; HR 0.329; 95% CI 0.131-0.830). A ROC curve analysis to assess the overall predictive performance of liver stiffness measurement on the HCC risk was performed. The results allow us to identify a cutoff value of liver stiffness measurement equal to 27.8 kPa, which guarantees the highest sensitivity and specificity (respectively, 72% and 65%). CONCLUSIONS: The data underline that the baseline liver stiffness measurement and ultrasound surveillance is a valuable tool for assessing the risk of HCC in cirrhotic patients undergoing the direct-acting antivirals treatment.
Authors: J Foucher; E Chanteloup; J Vergniol; L Castéra; B Le Bail; X Adhoute; J Bertet; P Couzigou; V de Lédinghen Journal: Gut Date: 2005-07-14 Impact factor: 23.059
Authors: Filomena Morisco; Rocco Granata; Tommaso Stroffolini; Maria Guarino; Laura Donnarumma; Laura Gaeta; Ilaria Loperto; Ivan Gentile; Francesco Auriemma; Nicola Caporaso Journal: World J Gastroenterol Date: 2013-05-14 Impact factor: 5.742
Authors: Lucia Cerrito; Maria Elena Ainora; Alberto Nicoletti; Matteo Garcovich; Laura Riccardi; Maurizio Pompili; Antonio Gasbarrini; Maria Assunta Zocco Journal: World J Hepatol Date: 2021-11-27