6533b861fe1ef96bd12c5ab1
RESEARCH PRODUCT
Material deprivation affects the management and clinical outcome of hepatocellular carcinoma in a high-resource environment
Alessandro CucchettiAnnagiulia GramenziPhilip JohnsonEdoardo GianniniFrancesco TovoliGian Ludovico RapacciniFabio MarraGiuseppe CabibboEugenio CaturelliAntonio GasbarriniGianluca Svegliati-baroniRodolfo SaccoMarco ZoliFilomena MoriscoMaria Di MarcoAndrea MegaFrancesco G. FoschiElisabetta BiasiniAlberto MasottoGerardo NardoneGiovanni RaimondoFrancesco AzzaroliGianpaolo VidiliMaurizia R. BrunettoFabio FarinatiFranco TrevisaniFrancesca AvanzatoMaurizio BiselliPaolo CaraceniFrancesca GarutiAnnagiulia GramenziAndrea NeriValentina SantiFilippo PellizzaroAngela ImondiAnna SartoriBarbara PenzoAmbra SanmarcoAlessandro GranitoLuca MuratoriFabio PiscagliaVito SansoneAntonella ForgioneElton DajtiGiovanni MarascoFederico RavaioliAlberta CappelliRita GolfieriCristina MosconiMatteo RenzulliEster Marina CelaAntonio FacciorussoValentina CacciatoEdoardo CasagrandeAlessandro MoscatelliGaia PellegattaNicoletta De MatthaeisGloria AllegriniValentina LauriaGiorgia GhittoniGiorgio PeleccaFabrizio ChegaiFabio CoratellaMariano OrtenziGabriele MissaleAndrea OlivaniAlessandro InnoFabiana MarchettiAnita BusaccaGiuseppe CabibboCalogero CammàVincenzo Di MartinoGiacomo Emanuele Maria RizzoMaria Stella FranzèCarlo SaittaAssunta SauchellaDante BerardinelliVittoria BevilacquaAlberto BorghiAndrea Casadei GardiniFabio ContiAnna Chiara Dall'aglioGiorgio ErcolaniValentina AdottiUmberto ArenaChiara Di BonaventuraClaudia CampaniGabriele DragoniStefano GittoGiacomo LaffiPietro CoccoliAntonio MalerbaMaria GuarinoMaria CapassoFilippo OliveriVeronica Romagnolisubject
Cancer Researchmedicine.medical_specialtySettore MED/12 - GastroenterologiaDeprivationbusiness.industryHepatocellular carcinomaPrognosiHazard ratioDeprivation; Hepatocellular carcinoma; Overall survival; Prognosis; Social determinants of healthmedicine.diseasePrognosisSocial determinants of healthOncologyInternal medicineHepatocellular carcinomamedicineOverall survivalOverall survivalSocial determinants of healthStage (cooking)businessLiver cancerSocioeconomic statusdescription
Abstract Aim This study investigated how material deprivation in Italy influences the stage of hepatocellular carcinoma (HCC) at diagnosis and the chance of cure. Methods 4114 patients from the Italian Liver Cancer database consecutively diagnosed with HCC between January 2008 and December 2018 were analysed about severe material deprivation (SMD) rate tertiles of the region of birth and region of managing hospitals, according to the European Statistics on Income and Living Conditions. The main outcomes were HCC diagnosis modalities (during or outside surveillance), treatment adoption and overall survival. Results In more deprived regions, HCC was more frequently diagnosed during surveillance, while the incidental diagnosis was prevalent in the least deprived. Tumour characteristics did not differ among regions. The proportion of patients undergoing potentially curative treatments progressively decreased as the SMD worsened. Consequently, overall survival was better in less deprived regions. Patients who moved from most deprived to less deprived regions increased their probability of receiving potentially curative treatments by 1.11 times (95% CI 1.03 to 1.19), decreasing their mortality likelihood (hazard ratio 0.78 95% CI 0.67 to 0.90). Conclusions Socioeconomic status measured through SMD does not seem to influence HCC features at diagnosis but brings a negative effect on the chance of receiving potentially curative treatments. Patient mobility from the most deprived to the less deprived regions increased the access to curative therapies, with the ultimate result of improving survival.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-11-01 |