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The changing scenario of hepatocellular carcinoma over the last two decades in Italy.

Abstract：

BACKGROUND & AIMS:This study investigates whether the aetiologic changes in liver disease and the improved management of hepatocellular carcinoma (HCC) have modified the clinical scenario of this tumour over the last 20 years in Italy. METHODS:Retrospective study based on the analysis of the ITA.LI.CA (Italian Liver Cancer) database including 3027 HCC patients managed in 11 centres. Patients were divided into 3 groups according to the period of HCC diagnosis: 1987-1996 (year of the "Milano criteria" publication), 1997-2001 (year of release of the EASL guidelines for HCC), and 2002-2008. RESULTS:The significant changes were: (1) progressive patient ageing; (2) increasing prevalence of HCV infection until 2001, with a subsequent decrease, when the alcoholic aetiology increased; (3) liver function improvement, until 2001; (4) increasing "incidental" at the expense of "symptomatic" diagnoses, until 2001; (5) unchanged prevalence of tumours diagnosed during surveillance (around 50%), with an increasing use of the 6-month schedule; (6) favourable HCC "stage migration", until 2001; (7) increasing use of percutaneous ablation; (8) improving survival, until 2001. CONCLUSIONS:Over the last 20 years, several aetiologic and clinical features regarding HCC have changed. The survival improvement observed until 2001 was due to an increasing number of tumours diagnosed in early stages and in a background of compensated cirrhosis, and a growing and better use of locoregional treatments. However, the prevalence of early cancers and survival did not increase further in the last years, a result inciting national policies aimed at implementing surveillance programmes for at risk patients.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Santi V,Buccione D,Di Micoli A,Fatti G,Frigerio M,Farinati F,Del Poggio P,Rapaccini G,Di Nolfo MA,Benvegnù L,Zoli M,Borzio F,Giannini EG,Caturelli E,Chiaramonte M,Bernardi M,Trevisani F

doi

10.1016/j.jhep.2011.05.026

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

397-405

issue

2

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(11)00531-9

journal_volume

56

pub_type

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