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Predictors of non-transplantable recurrence in hepatocellular carcinoma patients treated with frontline liver resection.
Pelizzaro, Filippo; Trevisani, Franco; Simeon, Vittorio; Vitale, Alessandro; Cillo, Umberto; Piscaglia, Fabio; Missale, Gabriele; Sangiovanni, Angelo; Foschi, Francesco G; Cabibbo, Giuseppe; Caturelli, Eugenio; Di Marco, Maria; Azzaroli, Francesco; Brunetto, Maurizia R; Raimondo, Giovanni; Vidili, Gianpaolo; Guarino, Maria; Gasbarrini, Antonio; Campani, Claudia; Svegliati-Baroni, Gianluca; Giannini, Edoardo G; Mega, Andrea; Masotto, Alberto; Rapaccini, Gian Ludovico; Magalotti, Donatella; Sacco, Rodolfo; Nardone, Gerardo; Farinati, Fabio.
Afiliación
  • Pelizzaro F; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
  • Trevisani F; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Simeon V; Unit of Semeiotics, Liver and Alcohol-related diseases, Department of Medical and Surgical Sciences, Università di Bologna, Bologna, Italy.
  • Vitale A; Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Cillo U; Medical Statistics Unit, Mental, Physical Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Napoli, Italy.
  • Piscaglia F; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
  • Missale G; Hepatobiliary Surgery and Liver Transplantation Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Sangiovanni A; Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
  • Foschi FG; Hepatobiliary Surgery and Liver Transplantation Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
  • Cabibbo G; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Caturelli E; Department of Medicine and Surgery, Unit of Infectious Diseases and Hepatology, University of Parma, Parma, Italy.
  • Di Marco M; Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Azzaroli F; Department of Internal Medicine, Ospedale per gli Infermi di Faenza, Faenza, Italy.
  • Brunetto MR; Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Italy.
  • Raimondo G; Gastroenterology Unit, Belcolle Hospital, Viterbo, Italy.
  • Vidili G; Medicine Unit, Bolognini Hospital, Seriate, Italy.
  • Guarino M; Gastroenterology Unit, Department of Surgical and Medical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Gasbarrini A; Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine Unit, University of Pisa, Pisa, Italy.
  • Campani C; Department of Clinical and Experimental Medicine, Clinical and Molecular Hepatology Unit, University of Messina, Messina, Italy.
  • Svegliati-Baroni G; Department of Medicine Surgery and Pharmacy, Centralized Day Hospital of the medical area, University of Sassari, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy.
  • Giannini EG; Department of Clinical Medicine and Surgery, Diseases of the Liver and Biliary System Unit, University of Napoli 'Federico II', Napoli, Italy.
  • Mega A; Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy.
  • Masotto A; Department of Experimental and Clinical Medicine, Internal Medicine and Hepatology Unit, University of Firenze, Firenze, Italy.
  • Rapaccini GL; Gastroenterology Unit, Polytechnic University of Marche, Ancona, Italy.
  • Magalotti D; Gastroenterology Unit, Department of Internal Medicine, University of Genova, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Sacco R; Gastroenterology Unit, Bolzano Regional Hospital, Bolzano, Italy.
  • Nardone G; Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy.
  • Farinati F; Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy.
Liver Int ; 43(12): 2762-2775, 2023 12.
Article en En | MEDLINE | ID: mdl-37753540
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) recurrence is common in patients treated with liver resection (LR). In this study, we aimed to evaluate the incidence and preoperative predictors of non-transplantable recurrence in patients with single HCC ≤5 cm treated with frontline LR. METHODS: From the Italian Liver Cancer (ITA.LI.CA) database, 512 patients receiving frontline LR for single HCC ≤5 cm were retrieved. Incidence and predictors of recurrence beyond Milan criteria (MC) and up-to-seven criteria were compared between patients with HCC <4 and ≥4 cm. RESULTS: During a median follow-up of 4.2 years, the overall recurrence rate was 55.9%. In the ≥4 cm group, a significantly higher proportion of patients recurred beyond MC at first recurrence (28.9% vs. 14.1%; p < 0.001) and overall (44.4% vs. 25.2%; p < 0.001). Similar results were found considering recurrence beyond up-to-seven criteria. Compared to those with larger tumours, patients with HCC <4 cm had a longer recurrence-free survival and overall survival. HCC size ≥4 cm and high alpha-fetoprotein (AFP) level at the time of LR were independent predictors of recurrence beyond MC (and up-to-seven criteria). In the subgroup of patients with available histologic information (n = 354), microvascular invasion and microsatellite lesions were identified as additional independent risk factors for non-transplantable recurrence. CONCLUSIONS: Despite the high recurrence rate, LR for single HCC ≤5 cm offers excellent long-term survival. Non-transplantable recurrence is predicted by HCC size and AFP levels, among pre-operatively available variables. High-risk patients could be considered for frontline LT or listed for transplantation even before recurrence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Liver Int Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Carcinoma Hepatocelular / Neoplasias Hepáticas Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Liver Int Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos