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.
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U2 - 10.1002/hep.27443
DO - 10.1002/hep.27443
M3 - Article
C2 - 25234419
AN - SCOPUS:84920939885
VL - 61
SP - 184
EP - 190
JO - Hepatology
JF - Hepatology
SN - 0270-9139
IS - 1
ER -