Application of the Intermediate-Stage Subclassification to Patients with Untreated Hepatocellular Carcinoma

Antonio Gasbarrini, Emanuele Rinninella, Edoardo G. Giannini, Alessandro Moscatelli, Gaia Pellegatta, Alessandro Vitale, Fabio Farinati, Francesca Ciccarese, Fabio Piscaglia, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Giuseppe Cabibbo, Martina Felder, Rodolfo Sacco, Filomena Morisco, Gabriele Missale, Francesco Giuseppe Foschi, Gianluca Svegliati BaroniRoberto Virdone, Alberto Masotto, Franco Trevisani, Luigi Bolondi, Maurizio Biselli, Paolo Caraceni, Alessandro Cucchetti, Marco Domenicali, Annagiulia Gramenzi, Donatella Magalotti, Anna Pecorelli, Carla Serra, Laura Venerandi, Alessia Gazzola, Francesca Murer, Caterina Pozzan, Veronica Vanin, Paolo Del Poggio, Stefano Olmi, Claudia Balsamo, Elena Vavassori, Luisa Benvegnù, Alberta Capelli, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Paola Roselli, Serena Dell'Isola, Anna Maria Ialungo, Elena Rastrelli, Andrea Mega, Valeria Mismas, Arianna Lanzi, Federica Mirici Cappa, Alessandro Musetto, Elga Neri, Giuseppe Francesco Stefanini, Alessandra Suzzi, Stefano Tamberi, Omero Triossi, Maria Chiaramonte, Fabiana Marchetti, Matteo Valerio

Risultato della ricerca: Contributo in rivistaArticolo in rivista

26 Citazioni (Scopus)

Abstract

OBJECTIVES:The Barcelona Clinic Liver Cancer (BCLC) intermediate stage (BCLC B) includes a heterogeneous population of patients with hepatocellular carcinoma (HCC). Recently, in order to facilitate treatment decisions, a panel of experts proposed to subclassify BCLC B patients. In this study, we aimed to assess the prognostic capability of the BCLC B stage reclassification in a large cohort of patients with untreated HCC managed by the Italian Liver Cancer Group.METHODS:We assessed the prognosis of 269 untreated HCC patients observed in the period 1987-2012 who were reclassified according to the proposed subclassification of the BCLC B stage from stage B1 to stage B4. We evaluated and compared the survival of the various substages.RESULTS:Median survival progressively decreased from stage B1 (n=65, 24.2%: 25 months) through stages B2 (n=105, 39.0%: 16 months) and B3 (n=22, 8.2%: 9 months), to stage B4 (n=77, 28.6%: 5 months; P<0.0001). Moreover, we observed a significantly different survival between contiguous stages (B1 vs. B2, P=0.0002; B2 vs. B3, P<0.0001; B3 vs. B4, P=0.0219). In multivariate analysis, the BCLC B subclassification (P<0.0001), MELD score (P=0.0013), and platelet count (P=0.0252) were independent predictors of survival.CONCLUSIONS:The subclassification of the intermediate-stage HCC predicts the prognosis of patients with untreated HCC. The prognostic figures identified in this study may be used as a benchmark to assess the efficacy of therapeutic intervention in the various BCLC B substages, whereas it remains to be established whether incorporation of the MELD score might improve the prognosis of treated patients.
Lingua originaleEnglish
pagine (da-a)70-77
Numero di pagine8
RivistaAmerican Journal of Gastroenterology
Volume111
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular
  • Female
  • Gastroenterology
  • Humans
  • Liver Neoplasms
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • Young Adult

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