Rise and fall of <scp>HCV</scp>‐related hepatocellular carcinoma in Italy: a long‐term survey from the <scp>ITA</scp>.<scp>LI</scp>.<scp>CA</scp> centres

Cazzagon, Nora; Trevisani, Franco; Maddalo, G.; Giacomin, A.; Vanin, V.; Pozzan, C.; Poggio, P. Del; Rapaccini, Gianludovico; Nolfo, Anna M. Di; Benvegnù, Luisa; Zoli, Marco; Borzio, Franco; Giannini, Edoardo G.; Caturelli, Eugenio; Chiaramonte, M.; Foschi, Francesco Giuseppe; Cabibbo, Giuseppe; Felder, Martina; Ciccarese, Francesca; Missale, Gabriele; Svegliati‐Baroni, Gianluca; Morisco, Filomena; Pecorelli, Anna; Farinati, Fabio

doi:10.1111/liv.12208

Cited by 15 publications

(15 citation statements)

References 38 publications

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“…e increase in the average age of HCC at diagnosis is a finding already reported in the literature [8,11,25], and our group had also detected a significant increase in age in a previous study conducted on a Sicilian population, comparing the epidemiology of the nineteennineties with those of the first decade of the twenty-first century [7].…”

Section: Age and Gendersupporting

confidence: 86%

“…e causes of this tumor coincide with those of liver cirrhosis, although there are epidemiological differences according to the geographical area considered. In detail, hepatitis B virus (HBV) etiology is prevalent in China, Southeast Asia, and sub-Saharan Africa [4,5], while chronic hepatitis C virus (HCV) is an important risk factor in western countries and Japan [6][7][8]. Chronic alcoholic liver diseases are reported worldwide, with the highest prevalence in Eastern and Central Europe (53 and 46%, respectively), sub-Saharan Africa (40%), and North America (37%) [9].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Age and Gendersupporting

confidence: 86%

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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“…Hepatocellular carcinoma (HCC) is among the five top‐ranking causes of cancer death worldwide . Its occurrence is frequently associated with fibrotic or cirrhotic chronic liver disease whose main etiology is either viral infection, hepatitis B virus or hepatitis C virus (HCV), or alcohol abuse . Autoimmune and biliary diseases account for a lower number of cases.…”

mentioning

confidence: 99%

Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study

et al. 2016

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on behalf of the HCC-NAFLD Italian Study Group* Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome and may evolve into hepatocellular carcinoma (HCC). Only scanty clinical information is available on HCC in NAFLD. The aim of this multicenter observational prospective study was to assess the clinical features of patients with NAFLD-related HCC (NAFLD-HCC) and to compare them to those of hepatitis C virus (HCV)-related HCC. A total of 756 patients with either NAFLD (145) or HCV-related chronic liver disease (611) were enrolled in secondary care Italian centers. Survival was modeled according to clinical parameters, lead-time bias, and propensity analysis. Compared to HCV, HCC in NAFLD patients had a larger volume, showed more often an infiltrative pattern, and was detected outside specific surveillance. Cirrhosis was present in only about 50% of NAFLD-HCC patients, in contrast to the near totality of HCV-HCC. Regardless of tumor stage, survival was significantly shorter (P 5 0.017) in patients with NAFLD-HCC, 25.5 months (95% confidence interval 21.9-29.1), than in those with HCV-HCC, 33.7 months (95% confidence interval 31.9-35.4). To eliminate possible confounders, a propensity score analysis was performed, which showed no more significant difference between the two groups. Additionally, analysis of patients within Milan criteria submitted to curative treatments did not show any difference in survival between NAFLD-HCC and HCV-HCC (respectively, 38.6 versus 41.0 months, P 5 nonsignificant) Conclusions: NAFLD-HCC is more often detected at a later tumor stage and could arise also in the absence of cirrhosis, but after patient matching, it has a similar survival rate compared to HCV infection; a future challenge will be to identify patients with NAFLD who require more stringent surveillance in order to offer the most timely and effective treatment. (HEPATOLOGY 2016;63:827-838)

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“…The vanishing effect of the first epidemic may have a profound impact on the burden of liver disease in Italy[5]: HCV infection might be considered mostly a feature of elderly subjects, and the mortality of HCV-related liver cancer is expected to decline in the years to come, which is line with the current observable trend[6]. …”

Section: Introductionmentioning

confidence: 99%

Mortality associated with hepatitis C and hepatitis B virus infection: A nationwide study on multiple causes of death data

Fedeli

Grande

Grippo

et al. 2017

WJG

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AIMTo analyze mortality associated with hepatitis C virus (HCV) and hepatitis B virus (HBV) infection in Italy.METHODSDeath certificates mentioning either HBV or HCV infection were retrieved from the Italian National Cause of Death Register for the years 2011-2013. Mortality rates and proportional mortality (percentage of deaths with mention of HCV/HBV among all registered deaths) were computed by gender and age class. The geographical variability in HCV-related mortality rates was investigated by directly age-standardized rates (European standard population). Proportional mortality for HCV and HBV among subjects aged 20-59 years was assessed in the native population and in different immigrant groups.RESULTSHCV infection was mentioned in 1.6% (n = 27730) and HBV infection in 0.2% (n = 3838) of all deaths among subjects aged ≥ 20 years. Mortality rates associated with HCV infection increased exponentially with age in both genders, with a male to female ratio close to unity among the elderly; a further peak was observed in the 50-54 year age group especially among male subjects. HCV-related mortality rates were higher in Southern Italy among elderly people (45/100000 in subjects aged 60-79 and 125/100000 in subjects aged ≥ 80 years), and in North-Western Italy among middle-aged subjects (9/100000 in the 40-59 year age group). Proportional mortality was higher among Italian citizens and North African immigrants for HCV, and among Sub-Saharan African and Asian immigrants for HBV.CONCLUSIONPopulation ageing, immigration, and new therapeutic approaches are shaping the epidemiology of virus-related chronic liver disease. In spite of limits due to the incomplete reporting and misclassification of the etiology of liver disease, mortality data represent an additional source of information for surveillance.

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Rise and fall of HCV‐related hepatocellular carcinoma in Italy: a long‐term survey from the ITA.LI.CA centres

Cited by 15 publications

References 38 publications

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

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

Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study

Mortality associated with hepatitis C and hepatitis B virus infection: A nationwide study on multiple causes of death data

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