TY - JOUR
T1 - Hepatocellular carcinoma in patients without cirrhosis in Italy
AU - Giannini, Edoardo G.
AU - Marenco, Simona
AU - Bruzzone, Linda
AU - Savarino, Vincenzo
AU - Farinati, Fabio
AU - Del Poggio, Paolo
AU - Rapaccini, Gian Ludovico
AU - Di Nolfo, Maria Anna
AU - Benvegnù, Luisa
AU - Zoli, Marco
AU - Borzio, Franco
AU - Caturelli, Eugenio
AU - Chiaramonte, Maria
AU - Trevisani, Franco
PY - 2013/2
Y1 - 2013/2
N2 - Background: In the Western world, hepatocellular carcinoma seldom develops in patients without cirrhosis, and reports describing the characteristics of non-cirrhotic patients with hepatocellular carcinoma are rather infrequent. Methods: We evaluated the main clinical characteristics, treatment options, and survival of patients with hepatocellular carcinoma developed in non-cirrhotic liver among the 3027 consecutive cases of hepatocellular carcinoma accrued in the Italian Liver Cancer database during the last 20 years. Results: We identified 52 patients with hepatocellular carcinoma in non-cirrhotic livers (1.7% of all hepatocellular carcinomas), 42 with (80.8%) and 10 without (19.2%) chronic liver disease. In patients without chronic liver disease, median tumour diameter was greater compared to patients with chronic liver disease (7.8 versus 4.0. cm, P= 0.046). Curative treatment was feasible in 20 patients (38.5%). Median overall survival was 26 months and 5-year survival rate was 23.7%. Detection of hepatocellular carcinoma outside surveillance (P= 0.036), advanced hepatocellular carcinoma stage (P<0.0001), and non-curative treatment (P= 0.007) were associated with worse prognosis, but tumour stage was the only independent predictor of survival. Conclusions: In Italy, less than 2% of hepatocellular carcinomas develop in a non-cirrhotic liver, and almost never in a normal liver. These patients frequently present with advanced tumours, have low eligibility rates for curative treatment, and have a dismal prognosis despite their preserved liver function.
AB - Background: In the Western world, hepatocellular carcinoma seldom develops in patients without cirrhosis, and reports describing the characteristics of non-cirrhotic patients with hepatocellular carcinoma are rather infrequent. Methods: We evaluated the main clinical characteristics, treatment options, and survival of patients with hepatocellular carcinoma developed in non-cirrhotic liver among the 3027 consecutive cases of hepatocellular carcinoma accrued in the Italian Liver Cancer database during the last 20 years. Results: We identified 52 patients with hepatocellular carcinoma in non-cirrhotic livers (1.7% of all hepatocellular carcinomas), 42 with (80.8%) and 10 without (19.2%) chronic liver disease. In patients without chronic liver disease, median tumour diameter was greater compared to patients with chronic liver disease (7.8 versus 4.0. cm, P= 0.046). Curative treatment was feasible in 20 patients (38.5%). Median overall survival was 26 months and 5-year survival rate was 23.7%. Detection of hepatocellular carcinoma outside surveillance (P= 0.036), advanced hepatocellular carcinoma stage (P<0.0001), and non-curative treatment (P= 0.007) were associated with worse prognosis, but tumour stage was the only independent predictor of survival. Conclusions: In Italy, less than 2% of hepatocellular carcinomas develop in a non-cirrhotic liver, and almost never in a normal liver. These patients frequently present with advanced tumours, have low eligibility rates for curative treatment, and have a dismal prognosis despite their preserved liver function.
KW - Alpha-fetoprotein
KW - Hepatocellular carcinoma
KW - Non-cirrhotic liver
KW - Survival
KW - Treatment
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U2 - 10.1016/j.dld.2012.08.018
DO - 10.1016/j.dld.2012.08.018
M3 - Article
C2 - 23047000
AN - SCOPUS:84872384938
VL - 45
SP - 164
EP - 169
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 2
ER -