Landscape of alcohol-related hepatocellular carcinoma in the last 15 years highlights the need to expand surveillance programs

Reggidori, Nicola; Bucci, Laura; Santi, Valentina; Stefanini, Benedetta; Lani, Lorenzo; Rampoldi, Davide; Ghittoni, Giorgia; Farinati, Fabio; Masotto, Alberto; Stefanini, Bernardo; Mega, Andrea; Biasini, Elisabetta; Foschi, Francesco Giuseppe; Svegliati‐Baroni, Gianluca; Sangiovanni, A.; Campani, Claudia; Raimondo, Giovanni; Vidili, Gianpaolo; Gasbarrini, Antonio; Celsa, Ciro; Marco, Mariella Di; Giannini, Edoardo G.; Sacco, Rodolfo; Brunetto, M.R.; Azzaroli, Francesco; Magalotti, Donatella; Morisco, Filomena; Rapaccini, Gian Ludovico; Nardone, Gerardo; Vitale, Alessandro; Trevisani, Franco; Biselli, Maurizio; Caraceni, Paolo; Gramenzi, Annagiulia; Benevento, Francesca; Granito, Alessandro; Muratori, L.; Piscaglia, Fabio; Tovoli, Francesco; Cammà, Calogero; Cabibbo, Giuseppe; Giacchetto, C; Giuffrida, Paolo; Grassini, Maria Vittoria; Grova, Mauro; Rancatore, Gabriele; Stornello, Caterina; Adotti, Valentina; Cavoli, Tancredi Li; Marra, Fabio; Rosi, Martina; Bevilacqua, Vittoria; Borghi, Alberto; Napoli, Lucia; Conti, Fabio; Frassineti, Giovanni Luca; Migliano, Maria Teresa; Allegrini, Gloria; Matthaeis, Nicoletta De; Ponziani, Francesca Romana; Missale, Gabriele; Olivani, Andrea; Capasso, Mario; Cossiga, Valentina; Gastroenterology, Maria Guarino.; Unit, Digestive Endoscopy; Hospital, Foggia University; Marina, Foggia: Ester; Facciorusso, Antonio; Graziosi, Camilla; Lauria, Valentina; Pelecca, Giorgio; Schirripa, Marta; Chegai, Fabrizio; Raso, Armando; Franzè, Alessio Bozzi.Maria Stella; Saitta, Carlo; Sauchella, Assunta; Dajti, Elton; Ravaioli, Federico; Torres, Maria Corina Plaz; Pieri, Giulia; Oliveri, Filippo; Ricco, Gabriele; Romagnoli, V.; Inno, Alessandro; Marchetti, Fabiana; Coccoli, Pietro; Malerba, Antonio; Cappelli, Alberta; Golfieri, Rita; Mosconi, Cristina; Renzulli, Matteo

doi:10.1016/j.jhepr.2023.100784

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…[8] Lastly, adherence to surveillance programs will likely represent a main issue, as in patients with alcoholassociated liver disease, it is suboptimal-3-fold lower than in patients with other etiologies-with a negative reflex on oncological stage at diagnosis, the likelihood of access to curative treatments, and ultimately patients' survival. [9,10] These findings underscore an urgent need for accurate and easily available tools to enhance the feasibility of HCC surveillance in the future. The use of abbreviated magnetic resonance imaging (AMRI) protocols is an appealing and promising surveillance modality that may obviate to the technical limitations of ultrasound in patients with central obesity.…”

Section: How Changing Epidemiology Of Chronic Liver Disease May Impac...mentioning

confidence: 96%

“…Thus, without additional, accurate features that may help adequately select high-risk patients it is likely that sustainability of surveillance programs may be at risk 8 . Lastly, adherence to surveillance programs will likely represent a main issue, as in patients with alcohol-associated liver disease, it is suboptimal—3-fold lower than in patients with other etiologies—with a negative reflex on oncological stage at diagnosis, the likelihood of access to curative treatments, and ultimately patients’ survival 9,10 …”

Section: How Changing Epidemiology Of Chronic Liver Disease May Impac...mentioning

confidence: 99%

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Proper assessment and prognostication of patients with hepatocellular carcinoma

Giannini

2024

Clinical Liver Disease

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Section: How Changing Epidemiology Of Chronic Liver Disease May Impac...mentioning

confidence: 96%

Section: How Changing Epidemiology Of Chronic Liver Disease May Impac...mentioning

confidence: 99%

Proper assessment and prognostication of patients with hepatocellular carcinoma

Giannini

2024

Clinical Liver Disease

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“…The BCLC-B subgroup comprises approximately 30% of the patients at the time of diagnosis, as indicated by large observational studies. 18 , 19 This subgroup includes a heterogeneous population, encompassing patients with significant differences both in terms of tumor burden and liver function. Several studies reported that patients classified within the BCLC-B stage exhibit a diverse range of survival times, highlighting the existence of certain limitations.…”

Section: Introductionmentioning

confidence: 99%

Intermediate-stage hepatocellular carcinoma: refining substaging or shifting paradigm?

Stefanini,

Ielasi,

Pallotta

et al. 2024

JLC

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This review explores the evolution of cancer staging, focusing on intermediate hepatocellular carcinoma (HCC), and the challenges faced by physicians. The Barcelona Clinic Liver Cancer (BCLC) staging system, introduced in 1999, was designed to address the limitations associated with providing accurate prognostic information for HCC and allocating specific treatments, to avoid overtreatment. However, criticism has emerged, particularly regarding the intermediate stage of HCC (BCLC-B) and its heterogeneous patient population. To overcome this limitation, various subclassification systems, such as the Bolondi and Kinki criteria, have been proposed. These systems are aimed at refining categorizations within the intermediate stage and have demonstrated varying degrees of success in predicting outcomes through external validation. This study discusses the shift in treatment paradigms, emphasizing the need for a more personalized approach rather than strictly adhering to cancer stages, without dismissing the relevance of staging systems. It assesses the available treatment options for intermediate-stage HCC, highlighting the importance of considering surgical and nonsurgical options alongside transarterial chemoembolization for optimal outcomes. In conclusion, the text advocates for a paradigm shift in staging systems prioritizing treatment suitability over cancer stage. This reflects the evolving landscape of HCC management, where a multidisciplinary approach is crucial for tailoring treatments to individual patients, ultimately aiming to improve overall survival.

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