Published 2018
| Version v1
Publication
Patients with advanced hepatocellular carcinoma need a personalized management: A lesson from clinical practice
Creators
- 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
- Svegliati Baroni, Gianluca
- Farinati, Fabio
- Rapaccini, Gian Lodovico
- 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
Contributors
Others:
- 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
- Svegliati Baroni, Gianluca
- Farinati, Fabio
- Rapaccini, Gian Lodovico
- 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
Description
The Barcelona Clinic Liver Cancer advanced stage (BCLC C) of hepatocellular carcinoma (HCC) includes a heterogeneous population, where sorafenib alone is the recommended treatment. In this study our aim was to assess treatment and overall survival (OS) of BCLC C patients sub-classified according to clinical features (Performance Status [PS], macro-vascular invasion [MVI], extra-hepatic spread [EHS] or MVI+EHS) determining their allocation to this stage. From the Italian Liver Cancer database, we analysed 835 consecutive BCLC C patients diagnosed between 2008 and 2014. Patients were sub-classified as: PS1 alone (n=385, 46.1%), PS2 alone (n=146, 17.5%), MVI (n=224, 26.8%), EHS (n=51, 6.1%) and MVI+EHS (n=29, 3.5%). MVI, EHS and MVI+EHS patients had larger and multifocal/massive HCCs and higher alpha-fetoprotein levels than PS1 and PS2 patients. Median OS significantly declined from PS1 (38.6 months) to PS2 (22.3 months), EHS (11.2 months), MVI (8.2 months) and MVI+EHS (3.1 months) (P<0.001). Among MVI patients, OS was longer in those with peripheral than with central (portal trunk) MVI (11.2 vs 7.1 months, P=0.005). The most frequent treatments were: curative approaches in PS1 (39.7%), supportive therapy in PS2 (41.8%), sorafenib in MVI (39.3%) and EHS (37.3%), and best supportive care in MVI+EHS patients (51.7%). Independent prognostic factors were: Model for End-stage Liver Disease score, Child-Pugh class, ascites, platelet count, albumin, tumour size, MVI, EHS, alpha-fetoprotein levels and treatment type.
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/884735
- URN
- urn:oai:iris.unige.it:11567/884735
Origin repository
- Origin repository
- UNIGE