The evolutionary scenario of hepatocellular carcinoma in Italy: an update
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 Zoli9, Franco Borzio10, Sacco Rodolfo11, Calogero Cammà12, Roberto Virdone13, Fabio Marra14, Martina Felder15, Filomena Morisco16, Luisa Benvegnù17, Antonio Gasbarrini18, Gianluca Svegliati-Baroni19, Francesco Giuseppe Foschi20, Gabriele Missale21, Alberto Masotto22, Gerardo Nardone23, Antonio Colecchia24, Mauro Bernardi1, Franco Trevisani1,* andThe Italian Liver Cancer (ITA.LI.CA) group.
DOI: 10.1111/liv.13204
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Liver International
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Epidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of etiology, 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 centers 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: 1) progressive patient aging; 2) progressive expansion of non-viral cases and, namely, of “metabolic” hepatocellular carcinomas; 3) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semiannual) surveillance program; 4) favourable cancer stage migration; 4) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; 5) improved outcomes of ablative and transarterial treatments; 6) 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 etiological and clinical features of hepatocellular carcinoma patients have changed, as their management. The observed improvement of overall survival was due both to the wider use of semiannual surveillance, expanding the proportion of tumors that qualified for curative treatments, and to the improved outcome of locoregional treatments.
This article is protected by copyright. All rights reserved.