在意大利肝癌的进化场景：更新

StephenW

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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Issue
Cover image for Vol. 36 Issue 8
Liver International

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    This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.13204


Keywords:

    Epidemiology;hepatocellular carcinoma;survival;treatment

Abstract
Background and aims

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.

StephenW

在意大利肝癌的进化场景：更新

    劳拉Bucci1，†，弗朗西斯Garuti1，†，芭芭拉Lenzi1，安娜Pecorelli2，法比奥Farinati3，爱德华多G. Giannini4，亚历山德罗Granito2，弗朗西斯Ciccarese5，吉安洛多维科Rapaccini6，玛丽亚·迪Marco7，欧金尼奥Caturelli8，马可Zoli9，佛朗哥Borzio10，萨科Rodolfo11，卡洛杰罗Cammà12，罗伯托Virdone13，法比奥Marra14，玛蒂娜Felder15，菲洛梅娜Morisco16，路易莎Benvegnù17，安东尼Gasbarrini18，赞布罗塔Svegliati-Baroni19，弗朗切斯科朱塞佩Foschi20，加布里埃莱Missale21，阿尔贝托Masotto22，赫拉尔Nardone2​​3，安东尼Colecchia24，毛罗Bernardi1，佛朗哥Trevisani1，* andThe意大利肝癌（ITA.LI.CA）组。

DOI：10.1111 / liv.13204

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封面图片的卷。 36第8
肝国际

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    这篇文章已被接受发表，并接受全面的同行评审，但经过审稿，排版，分页和校对过程中，这可能会导致这个版本和记录的版本之间的差异一直没有。请引用这篇文章的DOI：10.1111 / liv.13204


关键词：

    流行病学;肝细胞癌;生存;治疗

抽象
背景和目的

肝癌流行病学在世界范围内改变。本研究目的是在过去的15年评估病因，演示，管理，并在意大利肝细胞癌预后的变化情形。
方法

在ITA.LI.CA（意大利肝癌）数据库的回顾性分析，包括24个中心，从2000年到2014年的病人管理5192肝癌患者根据癌症诊断之日起（2000- 2004年2005-2009年分成三组和2010- 2014年）。
结果

主要结果如下：1）渐进病人老化; 2）非病毒案件，即逐步扩大的“新陈代谢”肝癌; 3）增加正确的（半年一次）监察计划期间诊断肝癌的比例; 4）有利于肿瘤分期迁移; 4）增加使用射频消融术，以无水酒精注射的损害; 5）提高了烧蚀和transarterial治疗结果; 6）提高了总生存率（调整在所调查的患者的前置时间），特别是2009年后，无论病毒和非病毒的患者的早期或中期肝细胞癌呈递的。
结论

在过去15年中肝细胞癌的患者的几个病原学和临床特征已经改变，因为它们的管理。总生存期的观察改进是两个原因，更广泛地使用每半年一次的监测，扩大认定为合格的治愈性治疗肿瘤的比例，以及局部的治疗方法改进的结果。

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