Metabolic disorders across hepatocellular carcinoma in Italy
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Liver international : official journal of the International Association for the Study of the Liver - 38(2018), 11 vom: 01. Nov., Seite 2028-2039 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Morisco, Filomena [VerfasserIn] |
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| Links: |
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| Themen: |
Diabetes |
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| Anmerkungen: |
Date Completed 01.08.2019 Date Revised 01.08.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/liv.13877 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM283923350 |
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| 100 | 1 | |a Morisco, Filomena |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Metabolic disorders across hepatocellular carcinoma in Italy |
| 264 | 1 | |c 2018 | |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a diabetes | |
| 650 | 4 | |a hepatocellular carcinoma | |
| 650 | 4 | |a metabolic syndrome | |
| 650 | 4 | |a obesity | |
| 700 | 1 | |a Guarino, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Valvano, Maria R |e verfasserin |4 aut | |
| 700 | 1 | |a Auriemma, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Farinati, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Giannini, Edoardo G |e verfasserin |4 aut | |
| 700 | 1 | |a Ciccarese, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Tovoli, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Rapaccini, Gian Ludovico |e verfasserin |4 aut | |
| 700 | 1 | |a Di Marco, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Caturelli, Eugenio |e verfasserin |4 aut | |
| 700 | 1 | |a Zoli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Borzio, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Sacco, Rodolfo |e verfasserin |4 aut | |
| 700 | 1 | |a Cabibbo, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Felder, Martina |e verfasserin |4 aut | |
| 700 | 1 | |a Benvengù, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Gasbarrini, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Svegliati Baroni, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Foschi, Francesco G |e verfasserin |4 aut | |
| 700 | 1 | |a Biasini, Elisabetta |e verfasserin |4 aut | |
| 700 | 1 | |a Masotto, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Virdone, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Marra, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Caporaso, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Trevisani, Franco |e verfasserin |4 aut | |
| 700 | 0 | |a Italian Liver Cancer (ITA.LI.CA) group |e verfasserin |4 aut | |
| 700 | 1 | |a Sessa, Anna |e investigator |4 oth | |
| 700 | 1 | |a Marafatto, Filippo |e investigator |4 oth | |
| 700 | 1 | |a Peserico, Giulia |e investigator |4 oth | |
| 700 | 1 | |a Pozzan, Caterina |e investigator |4 oth | |
| 700 | 1 | |a Brunacci, Matteo |e investigator |4 oth | |
| 700 | 1 | |a Moscatelli, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Pellegatta, Gaia |e investigator |4 oth | |
| 700 | 1 | |a Savarino, Vincenzo |e investigator |4 oth | |
| 700 | 1 | |a Del Poggio, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Olmi, Stefano |e investigator |4 oth | |
| 700 | 1 | |a de Matthaeis, Nicoletta |e investigator |4 oth | |
| 700 | 1 | |a Balsamo, Claudia |e investigator |4 oth | |
| 700 | 1 | |a Vavassori, Elena |e investigator |4 oth | |
| 700 | 1 | |a Roselli, Paola |e investigator |4 oth | |
| 700 | 1 | |a Lauria, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Pelecca, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Mismas, Valeria |e investigator |4 oth | |
| 700 | 1 | |a Rossi, Margherita |e investigator |4 oth | |
| 700 | 1 | |a Attardo, Simona |e investigator |4 oth | |
| 700 | 1 | |a Cavani, Giulia |e investigator |4 oth | |
| 700 | 1 | |a Mega, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Rinninella, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Ortolani, Alessio |e investigator |4 oth | |
| 700 | 1 | |a Bevilacqua, Vittoria |e investigator |4 oth | |
| 700 | 1 | |a Chiara Dall'Aglio, Anna |e investigator |4 oth | |
| 700 | 1 | |a Ercolani, Giorgio |e investigator |4 oth | |
| 700 | 1 | |a Fiorini, Erica |e investigator |4 oth | |
| 700 | 1 | |a Casadei Gardini, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Lanzi, Arianna |e investigator |4 oth | |
| 700 | 1 | |a Mirici Cappa, Federica |e investigator |4 oth | |
| 700 | 1 | |a Missale, Gabriele |e investigator |4 oth | |
| 700 | 1 | |a Porro, Emanuela |e investigator |4 oth | |
| 700 | 1 | |a Marchetti, Fabiana |e investigator |4 oth | |
| 700 | 1 | |a Valerio, Matteo |e investigator |4 oth | |
| 700 | 1 | |a Affronti, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Orlando, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a Rosa Barcellona, Maria |e investigator |4 oth | |
| 700 | 1 | |a Aburas, Sami |e investigator |4 oth | |
| 700 | 1 | |a Dragoni, Gabriele |e investigator |4 oth | |
| 700 | 1 | |a Campani, Claudia |e investigator |4 oth | |
| 700 | 1 | |a Biselli, Maurizio |e investigator |4 oth | |
| 700 | 1 | |a Bucci, Laura |e investigator |4 oth | |
| 700 | 1 | |a Caraceni, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Cucchetti, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Domenicali, Marco |e investigator |4 oth | |
| 700 | 1 | |a Garuti, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Gramenzi, Annagiulia |e investigator |4 oth | |
| 700 | 1 | |a Magalotti, Donatella |e investigator |4 oth | |
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| 700 | 1 | |a Napoli, Lucia |e investigator |4 oth | |
| 700 | 1 | |a Piscaglia, Fabio |e investigator |4 oth | |
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