6533b821fe1ef96bd127c26a
RESEARCH PRODUCT
Metabolic disorders across hepatocellular carcinoma in Italy
F. MoriscoM. GuarinoM. R. ValvanoF. AuriemmaF. FarinatiE. G. GianniniF. CiccareseF. TovoliGian Ludovico RapacciniM. Di MarcoE. CaturelliM. ZoliF. BorzioR. SaccoG. CabibboM. FelderL. BenvenguAntonio GasbarriniG. Svegliati BaroniF. G. FoschiE. BiasiniA. MasottoR. VirdoneF. MarraN. CaporasoF. TrevisaniA. SessaF. MarafattoG. PesericoC. PozzanM. BrunacciA. MoscatelliG. PellegattaV. SavarinoP. Del PoggioS. OlmiNicoletta De MatthaeisC. BalsamoE. VavassoriP. RoselliV. LauriaG. PeleccaV. MismasM. RossiS. AttardoG. CavaniA. MegaEmanuele RinninellaA. OrtolaniV. BevilacquaA. Chiara Dall'aglioG. ErcolaniCarlo Ettore FioriniA. Casadei GardiniAlessio LanziF. Mirici CappaG. MissaleE. PorroF. MarchettiM. ValerioA. AffrontiE. OrlandoM. Rosa BarcellonaS. AburasG. DragoniC. CampaniM. BiselliL. BucciP. CaraceniA. CucchettiM. DomenicaliF. GarutiA. GramenziD. MagalottiC. SerraA. GranitoG. NegriniL. NapoliF. Piscagliasubject
OncologyMaleobesityDatabases FactualHepatocellular carcinoma0302 clinical medicineRisk FactorsProspective cohort studydiabetesMetabolic disorderLiver NeoplasmsDiabeteshepatocellular carcinomaMiddle AgedMetabolic syndromePortal vein thrombosisItaly030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemalemedicine.medical_specialtyCarcinoma HepatocellularSettore MED/12 - GASTROENTEROLOGIADiabetes; Hepatocellular carcinoma; Metabolic syndrome; Obesitymetabolic syndrome03 medical and health sciencesDatabasesMetabolic DiseasesInternal medicinemedicineDiabetes MellitusHumansObesityFactualAgedNeoplasm StagingRetrospective StudiesHepatologybusiness.industryCarcinomaHepatocellularHepatologymedicine.diseaseSurvival AnalysisBCLC Stagediabetes; hepatocellular carcinoma; metabolic syndrome; obesity; Aged; Carcinoma Hepatocellular; Databases Factual; Diabetes Mellitus; Female; Humans; Italy; Liver Neoplasms; Male; Metabolic Diseases; Middle Aged; Multivariate Analysis; Neoplasm Staging; Obesity; Retrospective Studies; Risk Factors; Survival AnalysisdiabeteMultivariate AnalysisLiver functionMetabolic syndromebusinessdescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |