Application of the Intermediate-Stage Subclassification to Patients With Untreated Hepatocellular Carcinoma View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-01

AUTHORS

Edoardo G Giannini, Alessandro Moscatelli, Gaia Pellegatta, Alessandro Vitale, Fabio Farinati, Francesca Ciccarese, Fabio Piscaglia, Gian Lodovico Rapaccini, Maria Di Marco, Eugenio Caturelli, Marco Zoli, Franco Borzio, Giuseppe Cabibbo, Martina Felder, Rodolfo Sacco, Filomena Morisco, Gabriele Missale, Francesco Giuseppe Foschi, Antonio Gasbarrini, Gianluca Svegliati Baroni, Roberto Virdone, Alberto Masotto, Franco Trevisani, Italian Liver Cancer Group, 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, Giulia Bosco, Paola Roselli, Serena Dell'Isola, Anna Maria Ialungo, Elena Rastrelli, Antonino Picciotto, Vincenzo Savarino, Maria Rosa Barcellona, Calogero Cammà, Andrea Costantino, Andrea Affronti, Andrea Mega, Emanuele Rinninella, Valeria Mismas, Arianna Lanzi, Federica Mirici Cappa, Alessandro Musetto, Elga Neri, Giuseppe Francesco Stefanini, Alessandra Suzzi, Stefano Tamberi, Omero Triossi, Elisabetta Biasini, Emanuela Porro, Maria Guarino, Laura Schiadà, Maria Chiaramonte, Fabiana Marchetti, Matteo Valerio

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. More... »

PAGES

70

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/ajg.2015.389

DOI

http://dx.doi.org/10.1038/ajg.2015.389

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036744690

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26729544


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