Metabolic disorders across hepatocellular carcinoma in Italy

Gian Ludovico Rapaccini, Antonio Gasbarrini, Nicoletta De Matthaeis, Emanuele Rinninella, Filomena Morisco, Maria Guarino, Maria R. Valvano, Francesco Auriemma, Fabio Farinati, Edoardo G. Giannini, Francesca Ciccarese, Francesco Tovoli, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Rodolfo Sacco, Giuseppe Cabibbo, Martina Felder, Luisa BenvengùGianluca Svegliati Baroni, Francesco G. Foschi, Elisabetta Biasini, Alberto Masotto, Roberto Virdone, Fabio Marra, Nicola Caporaso, Franco Trevisani, Anna Sessa, Filippo Marafatto, Giulia Peserico, Caterina Pozzan, Matteo Brunacci, Alessandro Moscatelli, Gaia Pellegatta, Vincenzo Savarino, Paolo Del Poggio, Stefano Olmi, Claudia Balsamo, Elena Vavassori, Paola Roselli, Valentina Lauria, Giorgio Pelecca, Valeria Mismas, Margherita Rossi, Simona Attardo, Giulia Cavani, Andrea Mega, Alessio Ortolani, Vittoria Bevilacqua, Anna Chiara Dall'Aglio, Giorgio Ercolani, Erica Fiorini, Andrea Casadei Gardini, Arianna Lanzi, Federica Mirici Cappa, Gabriele Missale, Emanuela Porro, Fabiana Marchetti, Matteo Valerio, Andrea Affronti, Emanuele Orlando, Maria Rosa Barcellona, Sami Aburas, Gabriele Dragoni, Claudia Campani, Maurizio Biselli, Laura Bucci, Paolo Caraceni, Alessandro Cucchetti, Marco Domenicali, Francesca Garuti, Annagiulia Gramenzi, Donatella Magalotti, Carla Serra, Alessandro Granito, Giulia Negrini, Lucia Napoli, Fabio Piscaglia

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

Abstract

Background: Metabolic disorders are well-known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its aetiology. Methods: We analysed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analysed: BMI, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0-1, 2 and 3-5 metabolic features. Results: As compared with patients with 0-1 metabolic features, patients with 3-5 features showed lower percentage of HCC diagnosis on surveillance (P =.021), larger tumours (P =.038), better liver function (higher percentage of Child-Pugh class A [P =.007] and MELD < 10 [P =.003]), higher percentage of metastasis (P =.024) and lower percentage of portal vein thrombosis (P =.010). The BCLC stage and treatment options were similar among the 3 groups, with the exception of a less frequent access to loco-regional therapies for BCLC stage B patients with 3-5 features (P =.012). Overall survival and survival according to BCLC stage and/or treatment did not significantly differ among the 3 groups. Only using a probabilistic sensitivity analysis, diabetic patients showed a lower survival (P =.046). MELD score, HCC morphology, nodule size, BCLC stage, portal vein thrombosis and metastasis were independent predictors of lead-time adjusted survival. Conclusions: Our “real world” study suggests that metabolic disorders shape the clinical presentation of HCC but do not seem to play a major role in setting patient survival.
Lingua originaleEnglish
pagine (da-a)2028-2039
Numero di pagine12
RivistaLiver International
Volume38
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • diabetes
  • hepatocellular carcinoma
  • metabolic syndrome
  • obesity

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