The changing scenario of hepatocellular carcinoma over the last two decades in Italy

Santi, Valentina; Buccione, Daniela; Micoli, Antonio Di; Fatti, Gianluca; Frigerio, M.; Farinati, Fabio; Poggio, P. Del; Rapaccini, Gianludovico; Nolfo, Maria Anna Di; Benvegnù, Luisa; Zoli, Marco; Borzio, Franco; Giannini, Edoardo G.; Caturelli, Eugenio; Chiaramonte, M.; Bernardi, Mauro; Trevisani, Franco

doi:10.1016/j.jhep.2011.05.026

Cited by 89 publications

(94 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with current literature reported in both Western and Asian studies 34, 35, 36. In our study, this aging effect was observed only in patients with CHB‐related HCC.…”

Section: Discussionsupporting

confidence: 93%

“…As a result, patient survival significantly increased in the later era, which is a reflection of the various factors mentioned above. Other studies have also observed similar trends in survival 34, 37, 45, 46. Despite demonstrating a significant improvement of survival over time, the median survival of 18.6 months in the later era still seems rather low.…”

Section: Discussionsupporting

confidence: 58%

See 1 more Smart Citation

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Goh

Chang

et al. 2017

Hepatology Communications

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers globally. With advances in therapy for chronic viral hepatitis, changing social circumstances, and increasing practice of HCC surveillance, the epidemiology of HCC is expected to change over time. We explored the temporal trends in HCC in Singapore, a multiethnic Asian country, over the last 3 decades. Patients with HCC were prospectively enrolled and stratified into two cohorts (C1, 1988‐2002; C2, 2003‐2016). Patient and tumor characteristics, management, and survival were compared between the two cohorts, and a survival census was performed on October 31, 2015. There were 1,401 patients, and the mean age at diagnosis of HCC for C1 and C2 was 60.1 and 63.5 years, respectively. Male patient preponderance decreased significantly, with the male to female ratio falling from 5.2:1 to 3.9:1 between C1 and C2. Hepatitis B, although still the predominant risk factor for HCC, showed a significant decline from C1 to C2 (76.5% to 68.2%), while the nonviral etiology increased significantly over the same period (14.4% versus 25.0%, respectively). Significantly more patients in C2 than C1 were diagnosed through surveillance (39.2% versus 11.3%, respectively) and had better physical performance (Eastern Cooperative Oncology Group 0, 62.1% versus 20.4%, respectively). While Child‐Pugh status was comparable, significantly more patients in C2 than C1 had early stage disease (Barcelona Clinic Liver Cancer 0‐A, 39.5% versus 7.4%, respectively), which translated into significantly higher median survival (18.6 months versus 3.8 months, respectively). Conclusion: Over the past 3 decades, hepatitis B‐related HCC has been decreasing while HCC due to nonviral etiology has been increasing significantly. Surveillance to diagnose early stage HCC is important in improving the outcome of HCC. (Hepatology Communications 2017;1:564–571)

show abstract

“…This is consistent with current literature reported in both Western and Asian studies 34, 35, 36. In our study, this aging effect was observed only in patients with CHB‐related HCC.…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 58%

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Goh

Chang

et al. 2017

Hepatology Communications

View full text Add to dashboard Cite

show abstract

“…15,20,26 The survival rate of hepatocellular carcinoma cases was obtained by Santi et al, and corresponds to 78.7%, 50.4% and 28.9%, at 1, 3 and 5 y, respectively. 27 Five percent of patients requiring liver transplantation encounters transplant-related operative death, while the others have a 72% post-transplant survival rate 5 y after surgery. 24,28 Vaccine data.…”

Section: Epidemiological/clinical Data Incidence Of Acute Hepatitis mentioning

confidence: 99%

Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy

Boccalini

Taddei

Ceccherini

et al. 2013

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

“…It is widely accepted that the risk of developing hepatocellular carcinoma (HCC) is age-dependent [5] ; hence, in our countries, the diagnosis of HCC is more frequent in patients aged ≥ 70 years [6] . In fact, over the last two decades, the mean age of HCC patients at first diagnosis has progressively increased from 60 years in the mid-nineties to 70 years in more recent series [6][7][8][9][10][11] . Thus, facing with elderly cirrhotic patients with HCC is becoming a routine in clinical practice, and clinicians should be aware of the scenario that will characterize liver oncology in the near future.…”

Section: Introductionmentioning

confidence: 99%

Management of hepatocellular carcinoma in the elderly

Borzio

Dionigi

Parisi

et al. 2015

WJH

View full text Add to dashboard Cite

recommendation. We carried out a literature search in MEDLINE database for studies reporting on epidemiology, clinical characteristics and treatment outcome of HCC in elderly patients. Available data seem to indicate that in elderly patients the outcome of HCC is mostly influenced by liver function and tumor stage rather than by age and the latter should not influence treatment allocation. Age is not a risk for resection and older patients with resectable HCC and good liver function could gain benefit from surgery. Mild comorbidities do not seem a contraindication for surgery in aged patients. Conversely, major resection in elderly, even when performed in experienced high-volume centres, should be avoided. Both percutaneous ablation and transarterial chemoembolization are not contraindicated in aged patients and safety profile of these procedures is acceptable. Sorafenib is a viable option for advanced HCC in elderly provided that a careful evaluation of concomitant comorbidities, particularly cardiovascular ones, is taken into account. Available data seem to suggest that in either elderly and younger, treatment is a main predictor of outcome. Consequently, a nihilistic attitude of physicians towards under-or no-treatment of aged patients should not be longer justified. Core tip: The number of elderly patients with cancer is expected to rise in the next future, and facing with elderly cirrhotic patients with hepatocellular carcinoma (HCC) will characterize liver oncology scenario in the near future. International guidelines do not specifically address how to approach HCC in aged patients and no recommendations are available on age threshold to which clinical decisions should refer. Available data seem to rule out an intrinsic negative impact of age itself on HCC prognosis, and treatment allocation should be decided mainly according to HCC stage, liver residual function and general conditions. Indeed, a nihilistic AbstractMean age of hepatocellular carcinoma (HCC) patients has been progressively increasing over the last decades and ageing of these patients is becoming a real challenge in every day clinical practice. Unfortunately, international guidelines on HCC management do not address this problem exhaustively and do not provide any specific REVIEWSubmit a

show abstract

The changing scenario of hepatocellular carcinoma over the last two decades in Italy

Cited by 89 publications

References 30 publications

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy

Management of hepatocellular carcinoma in the elderly

Contact Info

Product

Resources

About