Prognosis of untreated hepatocellular carcinoma

Edoardo G. Giannini, Fabio Farinati, Francesca Ciccarese, Anna Pecorelli, Gian Lodovico Rapaccini, Mariella Di Marco, Luisa Benvegnù, Eugenio Caturelli, Marco Zoli, Franco Borzio, Maria Chiaramonte, Franco Trevisani

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

The prognosis of untreated patients with hepatocellular carcinoma (HCC) is heterogeneous, and survival data were mainly obtained from control arms of randomized studies. Clinical practice data on this topic are urgently needed, so as to help plan studies and counsel patients. We assessed the prognosis of 600 untreated patients with HCC managed by the Italian Liver Cancer Group. Prognosis was evaluated by subdividing patients according to the Barcelona Clinic Liver Cancer (BCLC) classification. We also assessed the main demographic, clinical, and oncological determinants of survival in the subgroup of patients with advanced HCC (BCLC C). Advanced (BCLC C: n=138; 23.0%) and end-stage HCC (BCLC D; n=210; 35.0%) represented the majority of patients. Overall median survival was 9 months, and the principal cause of death was tumor progression (n=279; 46.5%). Patients' median survival progressively and significantly decreased as BCLC stage worsened (BCLC 0: 38 months; BCLC A: 25 months; BCLC B: 10 months; BCLC C: 7 months; BCLC D: 6 months; P3) HCC (HR=1.79; 95% CI=1.21-2.63; P=0.003) were independent predictors of survival in patients with advanced HCC (BCLC C). Conclusion: BCLC adequately predicts the prognosis of untreated HCC patients. In untreated patients with advanced HCC, female gender, clinical decompensation of cirrhosis, and multinodular tumor are independent prognostic predictors and should be taken into account for patient stratification in future therapeutic studies.

Original languageEnglish
Pages (from-to)184-190
Number of pages7
JournalHepatology
Volume61
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Liver Neoplasms
Hepatocellular Carcinoma
Survival
Cause of Death
Neoplasms
Fibrosis
Demography

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

Cite this

Giannini, E. G., Farinati, F., Ciccarese, F., Pecorelli, A., Rapaccini, G. L., Di Marco, M., ... Trevisani, F. (2015). Prognosis of untreated hepatocellular carcinoma. Hepatology, 61(1), 184-190. https://doi.org/10.1002/hep.27443

Prognosis of untreated hepatocellular carcinoma. / Giannini, Edoardo G.; Farinati, Fabio; Ciccarese, Francesca; Pecorelli, Anna; Rapaccini, Gian Lodovico; Di Marco, Mariella; Benvegnù, Luisa; Caturelli, Eugenio; Zoli, Marco; Borzio, Franco; Chiaramonte, Maria; Trevisani, Franco.

In: Hepatology, Vol. 61, No. 1, 01.01.2015, p. 184-190.

Research output: Contribution to journalArticle

Giannini, EG, Farinati, F, Ciccarese, F, Pecorelli, A, Rapaccini, GL, Di Marco, M, Benvegnù, L, Caturelli, E, Zoli, M, Borzio, F, Chiaramonte, M & Trevisani, F 2015, 'Prognosis of untreated hepatocellular carcinoma', Hepatology, vol. 61, no. 1, pp. 184-190. https://doi.org/10.1002/hep.27443
Giannini EG, Farinati F, Ciccarese F, Pecorelli A, Rapaccini GL, Di Marco M et al. Prognosis of untreated hepatocellular carcinoma. Hepatology. 2015 Jan 1;61(1):184-190. https://doi.org/10.1002/hep.27443
Giannini, Edoardo G. ; Farinati, Fabio ; Ciccarese, Francesca ; Pecorelli, Anna ; Rapaccini, Gian Lodovico ; Di Marco, Mariella ; Benvegnù, Luisa ; Caturelli, Eugenio ; Zoli, Marco ; Borzio, Franco ; Chiaramonte, Maria ; Trevisani, Franco. / Prognosis of untreated hepatocellular carcinoma. In: Hepatology. 2015 ; Vol. 61, No. 1. pp. 184-190.
@article{66a8bf14e59d441cb9ca5398b01ff833,
title = "Prognosis of untreated hepatocellular carcinoma",
abstract = "The prognosis of untreated patients with hepatocellular carcinoma (HCC) is heterogeneous, and survival data were mainly obtained from control arms of randomized studies. Clinical practice data on this topic are urgently needed, so as to help plan studies and counsel patients. We assessed the prognosis of 600 untreated patients with HCC managed by the Italian Liver Cancer Group. Prognosis was evaluated by subdividing patients according to the Barcelona Clinic Liver Cancer (BCLC) classification. We also assessed the main demographic, clinical, and oncological determinants of survival in the subgroup of patients with advanced HCC (BCLC C). Advanced (BCLC C: n=138; 23.0{\%}) and end-stage HCC (BCLC D; n=210; 35.0{\%}) represented the majority of patients. Overall median survival was 9 months, and the principal cause of death was tumor progression (n=279; 46.5{\%}). Patients' median survival progressively and significantly decreased as BCLC stage worsened (BCLC 0: 38 months; BCLC A: 25 months; BCLC B: 10 months; BCLC C: 7 months; BCLC D: 6 months; P3) HCC (HR=1.79; 95{\%} CI=1.21-2.63; P=0.003) were independent predictors of survival in patients with advanced HCC (BCLC C). Conclusion: BCLC adequately predicts the prognosis of untreated HCC patients. In untreated patients with advanced HCC, female gender, clinical decompensation of cirrhosis, and multinodular tumor are independent prognostic predictors and should be taken into account for patient stratification in future therapeutic studies.",
author = "Giannini, {Edoardo G.} and Fabio Farinati and Francesca Ciccarese and Anna Pecorelli and Rapaccini, {Gian Lodovico} and {Di Marco}, Mariella and Luisa Benvegn{\`u} and Eugenio Caturelli and Marco Zoli and Franco Borzio and Maria Chiaramonte and Franco Trevisani",
year = "2015",
month = "1",
day = "1",
doi = "10.1002/hep.27443",
language = "English",
volume = "61",
pages = "184--190",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Prognosis of untreated hepatocellular carcinoma

AU - Giannini, Edoardo G.

AU - Farinati, Fabio

AU - Ciccarese, Francesca

AU - Pecorelli, Anna

AU - Rapaccini, Gian Lodovico

AU - Di Marco, Mariella

AU - Benvegnù, Luisa

AU - Caturelli, Eugenio

AU - Zoli, Marco

AU - Borzio, Franco

AU - Chiaramonte, Maria

AU - Trevisani, Franco

PY - 2015/1/1

Y1 - 2015/1/1

N2 - The prognosis of untreated patients with hepatocellular carcinoma (HCC) is heterogeneous, and survival data were mainly obtained from control arms of randomized studies. Clinical practice data on this topic are urgently needed, so as to help plan studies and counsel patients. We assessed the prognosis of 600 untreated patients with HCC managed by the Italian Liver Cancer Group. Prognosis was evaluated by subdividing patients according to the Barcelona Clinic Liver Cancer (BCLC) classification. We also assessed the main demographic, clinical, and oncological determinants of survival in the subgroup of patients with advanced HCC (BCLC C). Advanced (BCLC C: n=138; 23.0%) and end-stage HCC (BCLC D; n=210; 35.0%) represented the majority of patients. Overall median survival was 9 months, and the principal cause of death was tumor progression (n=279; 46.5%). Patients' median survival progressively and significantly decreased as BCLC stage worsened (BCLC 0: 38 months; BCLC A: 25 months; BCLC B: 10 months; BCLC C: 7 months; BCLC D: 6 months; P3) HCC (HR=1.79; 95% CI=1.21-2.63; P=0.003) were independent predictors of survival in patients with advanced HCC (BCLC C). Conclusion: BCLC adequately predicts the prognosis of untreated HCC patients. In untreated patients with advanced HCC, female gender, clinical decompensation of cirrhosis, and multinodular tumor are independent prognostic predictors and should be taken into account for patient stratification in future therapeutic studies.

AB - The prognosis of untreated patients with hepatocellular carcinoma (HCC) is heterogeneous, and survival data were mainly obtained from control arms of randomized studies. Clinical practice data on this topic are urgently needed, so as to help plan studies and counsel patients. We assessed the prognosis of 600 untreated patients with HCC managed by the Italian Liver Cancer Group. Prognosis was evaluated by subdividing patients according to the Barcelona Clinic Liver Cancer (BCLC) classification. We also assessed the main demographic, clinical, and oncological determinants of survival in the subgroup of patients with advanced HCC (BCLC C). Advanced (BCLC C: n=138; 23.0%) and end-stage HCC (BCLC D; n=210; 35.0%) represented the majority of patients. Overall median survival was 9 months, and the principal cause of death was tumor progression (n=279; 46.5%). Patients' median survival progressively and significantly decreased as BCLC stage worsened (BCLC 0: 38 months; BCLC A: 25 months; BCLC B: 10 months; BCLC C: 7 months; BCLC D: 6 months; P3) HCC (HR=1.79; 95% CI=1.21-2.63; P=0.003) were independent predictors of survival in patients with advanced HCC (BCLC C). Conclusion: BCLC adequately predicts the prognosis of untreated HCC patients. In untreated patients with advanced HCC, female gender, clinical decompensation of cirrhosis, and multinodular tumor are independent prognostic predictors and should be taken into account for patient stratification in future therapeutic studies.

UR - http://www.scopus.com/inward/record.url?scp=84920939885&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920939885&partnerID=8YFLogxK

U2 - 10.1002/hep.27443

DO - 10.1002/hep.27443

M3 - Article

VL - 61

SP - 184

EP - 190

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 1

ER -