Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 431-439 |
| Number of pages | 9 |
| Journal | Alimentary Pharmacology and Therapeutics |
| Volume | 48 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 1 2018 |
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Clinical features and outcomes of hepatocellular carcinoma in Caucasian cirrhotic patients on long-term analogue therapy for hepatitis B. / Loglio, A.; Iavarone, M.; Grossi, G.; Viganò, M.; Rumi, M. G.; Facchetti, F.; Lunghi, G.; Sangiovanni, A.; Colombo, M.; Lampertico, P.
In: Alimentary Pharmacology and Therapeutics, Vol. 48, No. 4, 01.08.2018, p. 431-439.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Clinical features and outcomes of hepatocellular carcinoma in Caucasian cirrhotic patients on long-term analogue therapy for hepatitis B
AU - Loglio, A.
AU - Iavarone, M.
AU - Grossi, G.
AU - Viganò, M.
AU - Rumi, M. G.
AU - Facchetti, F.
AU - Lunghi, G.
AU - Sangiovanni, A.
AU - Colombo, M.
AU - Lampertico, P.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Long-term oral nucleos(t)ide analogue (NUC) therapy in hepatitis B virus (HBV)-related compensated cirrhotics prevents clinical decompensation but not hepatocellular carcinoma (HCC) development. Aims: To define the clinical features and outcomes of HCC in long-term NUC-treated HBV patients. Methods: All HCCs developing between 2005 and 2016 in NUC-treated HBV patients under surveillance were studied, excluding those that occurred within the first 6 months of therapy. Clinical features of HCC, alpha faetoprotein (AFP) patterns and patients' outcome were studied. Results: Seventy-six HCC patients were included. Median age was 67 (40-83) years, 84% males, 96% Caucasian, 95% HBeAg-negative, 96% with undetectable HBV DNA, 83% with normal ALT levels, and 92% with compensated cirrhosis. Median serum AFP levels were 4 (1-3615) ng/mL (>7 ng/mL in 36%). HCC was monofocal in 78%, had a median diameter of 20 (6-57) mm and was in its early stage in 92% which allowed potentially curative treatments in 78% (39% ablation, 28% surgical resection, 11% liver transplantation). Overall, a complete response was obtained in 61 (80%) patients: in 40 after a first-line treatment, in 3 after the second–line treatment, in 2 after the third-line treatment, while 16 underwent liver transplantation (8 as second line). During 45 (7-144) months after HCC diagnosis, 19 patients died, 84% from HCC progression. The median time to recurrence was 20.2 (3-53) months, and the cumulative 5-year liver-related survival was 74%. Conclusions: HCCs developing in patients under long-term NUC treatment were single, small tumours, amenable to curative therapies able to confer excellent 5-year survival rates.
AB - Background: Long-term oral nucleos(t)ide analogue (NUC) therapy in hepatitis B virus (HBV)-related compensated cirrhotics prevents clinical decompensation but not hepatocellular carcinoma (HCC) development. Aims: To define the clinical features and outcomes of HCC in long-term NUC-treated HBV patients. Methods: All HCCs developing between 2005 and 2016 in NUC-treated HBV patients under surveillance were studied, excluding those that occurred within the first 6 months of therapy. Clinical features of HCC, alpha faetoprotein (AFP) patterns and patients' outcome were studied. Results: Seventy-six HCC patients were included. Median age was 67 (40-83) years, 84% males, 96% Caucasian, 95% HBeAg-negative, 96% with undetectable HBV DNA, 83% with normal ALT levels, and 92% with compensated cirrhosis. Median serum AFP levels were 4 (1-3615) ng/mL (>7 ng/mL in 36%). HCC was monofocal in 78%, had a median diameter of 20 (6-57) mm and was in its early stage in 92% which allowed potentially curative treatments in 78% (39% ablation, 28% surgical resection, 11% liver transplantation). Overall, a complete response was obtained in 61 (80%) patients: in 40 after a first-line treatment, in 3 after the second–line treatment, in 2 after the third-line treatment, while 16 underwent liver transplantation (8 as second line). During 45 (7-144) months after HCC diagnosis, 19 patients died, 84% from HCC progression. The median time to recurrence was 20.2 (3-53) months, and the cumulative 5-year liver-related survival was 74%. Conclusions: HCCs developing in patients under long-term NUC treatment were single, small tumours, amenable to curative therapies able to confer excellent 5-year survival rates.
U2 - 10.1111/apt.14848
DO - 10.1111/apt.14848
M3 - Article
VL - 48
SP - 431
EP - 439
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 4
ER -