TY - JOUR
T1 - The changing scenario of hepatocellular carcinoma in Italy: an update
AU - the ITA.LI.CA study group
AU - Garuti, Francesca
AU - Neri, Andrea
AU - Avanzato, Francesca
AU - Gramenzi, Annagiulia
AU - Rampoldi, Davide
AU - Rucci, Paola
AU - Farinati, Fabio
AU - Giannini, Edoardo G.
AU - Piscaglia, Fabio
AU - Rapaccini, Gian Ludovico
AU - Di Marco, Maria
AU - Caturelli, Eugenio
AU - Zoli, Marco
AU - Sacco, Rodolfo
AU - Cabibbo, Giuseppe
AU - Marra, Fabio
AU - Mega, Andrea
AU - Morisco, Filomena
AU - Gasbarrini, Antonio
AU - Svegliati-Baroni, Gianluca
AU - Foschi, Francesco G.
AU - Missale, Gabriele
AU - Masotto, Alberto
AU - Nardone, Gerardo
AU - Raimondo, Giovanni
AU - Azzaroli, Francesco
AU - Vidili, Gianpaolo
AU - Brunetto, Maurizia R.
AU - Trevisani, Franco
N1 - Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background and aims: Epidemiology of hepatocellular carcinoma (HCC) is changing in most areas of the world. This study aimed at updating the changing scenario of aetiology, clinical presentation, management and prognosis of HCC in Italy during the last 15 years. Methods: Retrospective analysis of the Italian Liver Cancer (ITA.LI.CA) database included 6034 HCC patients managed in 23 centres from 2004 to 2018. Patients were divided into three groups according to the date of cancer diagnosis (2004-2008, 2009-2013 and 2014-2018). Results: The main results were: (i) a progressive patient ageing; (ii) a progressive increase of non-viral cases and, particularly, of ‘metabolic’ and ‘metabolic + alcohol’ HCCs; (iii) a slightly decline of cases diagnosed under surveillance, but with an incremental use of the semiannual schedule; (iv) a favourable cancer stage migration; (v) an increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) an improved overall survival (adjusted for the lead time in surveyed patients) in the last calendar period, particularly in viral patients; (viii) a large gap between the number of potential candidates (according to oncologic criteria and age) to liver transplant and that of transplanted patients. Conclusions: During the last 15 years several aspects of HCC scenario have changed, as well as its management. The improvement in patient survival observed in the last period was likely because of a larger use of thermal ablation with respect to the less effective alcohol injection and to an improved management of intermediate stage patients.
AB - Background and aims: Epidemiology of hepatocellular carcinoma (HCC) is changing in most areas of the world. This study aimed at updating the changing scenario of aetiology, clinical presentation, management and prognosis of HCC in Italy during the last 15 years. Methods: Retrospective analysis of the Italian Liver Cancer (ITA.LI.CA) database included 6034 HCC patients managed in 23 centres from 2004 to 2018. Patients were divided into three groups according to the date of cancer diagnosis (2004-2008, 2009-2013 and 2014-2018). Results: The main results were: (i) a progressive patient ageing; (ii) a progressive increase of non-viral cases and, particularly, of ‘metabolic’ and ‘metabolic + alcohol’ HCCs; (iii) a slightly decline of cases diagnosed under surveillance, but with an incremental use of the semiannual schedule; (iv) a favourable cancer stage migration; (v) an increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) an improved overall survival (adjusted for the lead time in surveyed patients) in the last calendar period, particularly in viral patients; (viii) a large gap between the number of potential candidates (according to oncologic criteria and age) to liver transplant and that of transplanted patients. Conclusions: During the last 15 years several aspects of HCC scenario have changed, as well as its management. The improvement in patient survival observed in the last period was likely because of a larger use of thermal ablation with respect to the less effective alcohol injection and to an improved management of intermediate stage patients.
KW - epidemiology
KW - hepatocellular carcinoma
KW - survival
KW - treatment
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U2 - 10.1111/liv.14735
DO - 10.1111/liv.14735
M3 - Article
C2 - 33219585
AN - SCOPUS:85096959956
JO - Liver International
JF - Liver International
SN - 1478-3223
ER -