Hepatocellular carcinoma in patients without cirrhosis in Italy.

Background: In the Western world, hepatocellular carcinoma seldom develops in patients without cirrhosis, and reports describing the characteristics of non-cirrhotic patients with hepatocellular carcinoma are rather infrequent.

Methods: We evaluated the main clinical characteristics, treatment options, and survival of patients with hepatocellular carcinoma developed in non-cirrhotic liver among the 3027 consecutive cases of hepatocellular carcinoma accrued in the Italian Liver Cancer database during the last 20 years.

Results: We identified 52 patients with hepatocellular carcinoma in non-cirrhotic livers (1.

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

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.

Changing aetiological factors of hepatocellular carcinoma and their potential impact on the effectiveness of surveillance.

Background: The aetiological factors of hepatocellular carcinoma may vary over time.

Aims: The study assessed the potential impact of the aetiological factors on the effectiveness of surveillance in real-world patients.

Methods: Multicentre, cross-sectional study enrolling consecutive hepatocellular carcinoma cases during a six month period.

Barcelona Clinic Liver Cancer staging and transplant survival benefit for patients with hepatocellular carcinoma: a multicentre, cohort study.

Background: Allocation of deceased-donor livers to patients with chronic liver failure is improved by prioritising patients by 5-year liver transplantation survival benefit. The Barcelona Clinic Liver Cancer (BCLC) staging has been proposed as the standard means to assess for prognosis of patients with hepatocellular carcinoma. We aimed to create a prediction model linking the BCLC stage of patients with hepatocellular carcinoma to their 5-year liver transplant benefit.

Relative decrease in the role played by hepatitis B virus infection in the aetiology of hepatocellular carcinoma during a 20-year period: a multicentre Italian study.

Background: Chronic hepatitis B virus (HBV) infection is one of the most frequent aetiological factors associated with the development of hepatocellular carcinoma (HCC).

Aim: This study evaluated the temporal trend in the aetiological role played by HBV infection alone in patients diagnosed with HCC during the last 20 years in Italy.

Methods: Among the 2042 HCC patients included in the Italian Liver Cancer (ITA.

Semiannual surveillance is superior to annual surveillance for the detection of early hepatocellular carcinoma and patient survival.

Background & Aims: The current guidelines recommend the surveillance of cirrhotic patients for early diagnosis of hepatocellular carcinoma (HCC), based on liver ultrasonography repetition at either 6 or 12 month intervals, since there is no compelling evidence of superiority of the more stringent program. This study aimed at comparing cancer stage, treatment applicability, and survival between patients on semiannual or annual surveillance.

Methods: We analyzed the clinical records of 649 HCC patients in Child-Pugh class A or B, observed in ITA.

Treatments for hepatocellular carcinoma in elderly patients are as effective as in younger patients: a 20-year multicentre experience.

Objectives: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) is expected to increase. We compared the presenting features and outcome of HCC in elderly (>or=70 years) and younger patients (<70 years).

Design: Multicentre retrospective cohort study and nested case-control study.

Is female sex a significant favorable prognostic factor in hepatocellular carcinoma?

Objective: As sex favorably modulates the natural history of chronic liver diseases and the risk for neoplastic evolution, our study aimed to ascertain whether female hepatocellular carcinoma (HCC) patients are also characterized by better prognosis.

Methods: The ITA.LI.

Hepatocellular carcinoma in patients with cryptogenic cirrhosis.

Background & Aims: Patients with cryptogenic cirrhosis (CC) can develop hepatocellular carcinoma (HCC), although the clinical characteristics of HCC in these patients have not been completely defined. We aimed to characterize the clinical features of patients diagnosed with HCC after CC during a 15-year period (1992-2006).

Methods: The clinical characteristics of 45 consecutive CC patients with HCC were analyzed, along with modality of diagnosis, tumor stage, treatment, survival, and causes of death.

Early and very early hepatocellular carcinoma: when and how much do staging and choice of treatment really matter? A multi-center study.

Background: A consensus on the most reliable staging system for hepatocellular carcinoma (HCC) is still lacking but the most used is a revised Barcelona Clinic Liver Cancer (BCLC) system, adopted by the American Association for the Study of Liver Diseases (AASLD). We investigated how many patients are diagnosed in "very early" and "early" stage, follow the AASLD guidelines for treatment and whether their survival depends on treatment.

Methods: Data were collected in 530 "very early" and "early" HCC patients recruited by a multicentric Italian collaborative group (ITA.

Surveillance for early diagnosis of hepatocellular carcinoma: is it effective in intermediate/advanced cirrhosis?

Objectives: Surveillance of cirrhotic patients for early diagnosis of hepatocellular carcinoma (HCC), based on ultrasonography and alpha-fetoprotein (AFP) measurement, is widely used. Its effectiveness depends on liver function, which affects the feasibility of treatments and cirrhosis-related mortality. We assessed whether patients with intermediate/advanced cirrhosis benefit from surveillance.

Impact of etiology of cirrhosis on the survival of patients diagnosed with hepatocellular carcinoma during surveillance.

Objectives: Although the etiology of liver disease affects the features of hepatocellular carcinoma (HCC) diagnosed during surveillance, it is not known whether it influences patients' survival. We analyzed the impact of etiology on the characteristics and outcome of HCC detected during surveillance.

Methods: In this cohort study, 742 patients with HCC detected during semiannual or annual surveillance were selected from the ITA.

Prevalence and prognostic significance of the presence of esophageal varices in patients with hepatocellular carcinoma.

Background & Aims: It has been suggested that clinically relevant portal hypertension may affect the therapeutic management and prognosis of cirrhotic patients with hepatocellular carcinoma (HCC). Nevertheless, the importance of the presence of esophageal varices in these patients has not yet been addressed formally. In this study our aim was to evaluate the prevalence and prognostic relevance of the presence of esophageal varices in a large series of patients with HCC.

Diagnostic and prognostic role of alpha-fetoprotein in hepatocellular carcinoma: both or neither?

Background: The clinical usefulness of alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC) management is debatable.

Objectives: To assess, in a large multi-centric survey, diagnostic and prognostic reliability of AFP, predictive factors, and any correlation with the tumor immunophenotype.

Methods: A total of 1,158 patients with HCC were analyzed with reference to serum AFP levels at diagnosis.

Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma.

Objectives: The aim of this study was to assess whether hepatocellular carcinoma occurring in the setting of hepatitis B or C virus infection has different prognosis.

Methods: We performed a multicentric case-control study comparing 102 pairs of patients affected by hepatitis B virus- or hepatitis C virus-related hepatocellular carcinoma. Patients were matched for sex (male/female: 84/18 pairs), age, center, and period of enrollment, underlying chronic liver disease (cirrhosis/chronic hepatitis: 97/5 pairs), Child-Pugh class (A/B/C: 70/25/7 pairs), hepatocellular carcinoma stage (nonadvanced/advanced: 50/52 pairs) and, when possible, modality of cancer diagnosis (75 pairs: 47 during and 28 outside surveillance).

Surveillance for hepatocellular carcinoma in elderly Italian patients with cirrhosis: effects on cancer staging and patient survival.

Objectives: Surveillance of cirrhotic individuals for early detection of HCC, based on ultrasonography (US) and alpha1-fetoprotein (AFP) determination, is a recommended practice currently applied also to elderly patients. However, several age-related factors may jeopardize the results of surveillance in these patients. Aim of the study was to evaluate the benefit of surveillance for HCC in elderly individuals.