Metabolic disorders across hepatocellular carcinoma in Italy

Morisco, Filomena; Guarino, Maria; Valvano, Maria Rosa; Auriemma, Francesco; Farinati, Fabio; Giannini, Edoardo G.; Ciccarese, Francesca; Tovoli, Francesco; Rapaccini, Gian Ludovico; Marco, Maria Di; Caturelli, Eugenio; Zoli, Marco; Borzio, Franco; Sacco, Rodolfo; Cabibbo, Giuseppe; Felder, Martina; Benvengù, Luisa; Gasbarrini, Antonio; Svegliati‐Baroni, Gianluca; Foschi, Francesco Giuseppe; Biasini, Elisabetta; Masotto, Alberto; Virdone, Roberto; Marra, Fabio; Caporaso, N.; Trevisani, Franco

doi:10.1111/liv.13877

Cited by 11 publications

(17 citation statements)

References 44 publications

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“…The strong statistical power allowed by our large sample size may explain that we could report an independent association between tobacco consumption and mortality after HCC diagnosis, even if the effect size is small (mean survival reduced by 1.6 months) and only opens modest perspectives for secondary prevention. We did not observe an independent association between diabetes and the evolution of HCC, in line with previous evidence [9]. However, we observed a significant, though modest, better prognostic among patients with baseline hypertension (mean survival improved by 1.5 months), contradicting the results observed European patients [9].…”

Section: Discussionsupporting

confidence: 83%

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confidence: 99%

“…HCC etiology may also affect response to treatment and survival [8]. Other conditions, such as metabolic disorders, may affect HCC incidence, but their influence on survival is not clearly established [9]. Better identification of individual prognostic factors among patients with HCC in the specific context of Egypt may provide valuable insight into patients’ care and treatment.…”

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confidence: 99%

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Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study

Jean

Tawheed

Nguye

et al. 2022

Preprint

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Context: We aimed to assess temporal changes in the presentation and survival of patients with hepatocellular carcinoma (HCC) in the northern Egypt region, one of the regions reporting the highest incidence of the disease globally. Method: We conducted a monocentric retrospective study. Patients presenting at the Damietta Oncology referral center between 2007 and 2019 with a diagnosed HCC were eligible. Individual, clinical and tumor characteristics at HCC diagnosis, including the Barcelona Clinic Liver Cancer (BCLC) staging, were retrieved from medical files and patients final vital status was ascertained by combining various data sources. Patients were divided into 2 groups based on diagnosis period: pre- and post-2014. Survival was analysed based on Kaplan-Meier curves and differences in restricted mean survival time (RMST). Results: Data from 5,097 patients (among 5,210 eligible, 97.8%) wereere analyzed. We observed a significant trend toward HCC diagnosed at earlier stage in the post- vs. pre-2014 period (BCLC stage 0/A or B: 37.2% vs. 27.1%, p<10-3). Overall patient's survival after the HCC diagnosis was poor, with a median of 8.1 months. The BCLC staging system performed well in predicting survival (median survival for patients diagnosed with BCLC stage 0/A, B, C, and D: 28, 25, 7, and 4 months, respectively, p<10-3). Despite a trend toward HCC diagnosed at earlier stages, we did not observe a significant improvement in survival over time. Overall, treatments offered in this medical center were in line with international guidelines, and 16.1% of the patients who received a curative treatment had an improved survival (30.7 months in median). However, HCC recurrence was frequent among patients cured for HCC, with a median time to recurrence of 22 months. Conclusion: Overall survival after HCC diagnosis in Egypt remains poor but is significantly improved by curative therapy. Despite a trend toward earlier diagnosis of HCC, we did not observe a general improvement in survival over time, which remains to be clearly understood.

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Section: Discussionsupporting

confidence: 83%

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confidence: 99%

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confidence: 99%

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Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study

Jean

Tawheed

Nguye

et al. 2022

Preprint

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“…Studies in the United States, Canada, Australia, New Zealand, and much of Europe, and also the Philippines and Guatemala, have shown increases in cases of HCV and alcohol-related HCC of 42% and 56%, respectively [1,3,[14][15][16][17][18][19][20][21][22]. In western countries, there is an increasing incidence of post-NASH HCC [11,12,[22][23][24]. e use of direct antivirals (DAAs) may also affect HCC epidemiology in the coming years.…”

Section: Introductionmentioning

confidence: 99%

The Changing Epidemiology of Hepatocellular Carcinoma : Experience of a Single Center

Giannitrapani

Zerbo

Amodeo

et al. 2020

BioMed Research International

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Aims. To analyze the main etiological factors and some clinical features of patients with hepatocellular carcinoma (HCC) at diagnosis and to compare them with those we described ten years ago. Materials and Methods. We compared two groups of patients with HCC, Group 1 consisting of 132 patients (82 M, 50 F) diagnosed in the 2003-2008 period and Group 2 including 119 patients (82 M, 37 F) diagnosed in the 2013-2018 period. For all patients, age, sex, viral markers, alcohol consumption, serum alpha-fetoprotein (AFP) levels, and the main liver function parameters were recorded. e diagnosis of HCC was based on AASLD, EASL guidelines. e staging was classified according to the "Barcelona Clinic Liver Cancer staging system" (BCLC). Results. Mean age was 69.0 ± 8 years in Group 1 and 71.0 ± 9 in Group 2 (P < 0.05). HCV subjects were significantly older in Group 2 (P < 0.05), and there was no difference for those with other etiologies. e main etiology in the two groups was HCV 80% (Group 1) versus 73% (Group 2) (P � ns), and there was no difference for HBV. Nonviral etiology was higher in Group 2 versus Group 1 (17% versus 9%; P < 0.05). e Child class at diagnosis showed no difference between the two groups, whereas in Group 2 the HCC staging according to BCLC was less severe (P < 0.02). When comparing the viral versus post-NASH BCLC in patients of the second period alone, the staging was more severe in the latter (P < 0.01). AFP serum levels were normal in 37% of cases in Group 1 and in 67% in Group 2 (P < 0.0001) and were less frequently diagnostic in post-NASH than in other etiologies (P < 0.03).Conclusions. is study shows that over the last decade a number of features of patients with HCC in our region have changed, particularly age at onset, etiological factors, and staging of HCC.

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“…For example, many studies have shown a strong correlation between metabolic comorbidities [type 2 diabetes mellitus, high body mass index (BMI) and concomitant presence of steatosis] and HCC risk. The presence of these comorbidities has been associated with both increased risk of HCC development and cancer related mortality (12,13). For these reasons, European guidelines recommend that patients with cofactors for liver diseases, regardless fibrotic degree, should continue surveillance for HCC, even after HCV eradication (1).…”

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confidence: 99%

Risk stratification of HCC occurrence after HCV eradication: a complicate plot of risk factors related and unrelated to the previous viral disease

Cossiga

Guarino

Morisco

et al. 2020

Hepatobiliary Surg Nutr

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Metabolic disorders across hepatocellular carcinoma in Italy

Abstract: Our "real world" study suggests that metabolic disorders shape the clinical presentation of HCC but do not seem to play a major role in setting patient survival.

Cited by 11 publications

References 44 publications

Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study

Changes in presentation, treatment, and survival of patients with hepatocellular carcinoma in Damietta, Egypt, 2007-2019: a retrospective monocentric cohort study

The Changing Epidemiology of Hepatocellular Carcinoma : Experience of a Single Center

Risk stratification of HCC occurrence after HCV eradication: a complicate plot of risk factors related and unrelated to the previous viral disease

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