The evolutionary scenario of hepatocellular carcinoma in Italy: an update
The evolutionary scenario of hepatocellular carcinoma in Italy: an update
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DOI：
10.1111/liv.13204
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发表时间：
2017-02-01
影响因子：
6.7
通讯作者：
Trevisani, Franco
中科院分区：
文献类型：
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作者：
Bucci, Laura;Garuti, Francesca;Trevisani, Franco
背景与目的肝细胞癌的流行病学在世界范围内正在发生变化。本研究旨在评估意大利在过去15年中肝细胞癌的病因、表现、管理和预后的变化情况。方法回顾性分析ITA.LI.CA（意大利肝癌）数据库，包括2000年至2014年在24个中心管理的5192例肝细胞癌患者。根据癌症诊断日期将患者分为三组结果主要结果如下：（i）患者年龄逐渐老化;（ii）非病毒性肝细胞癌（即代谢性肝细胞癌）的逐渐扩大;（iii）非病毒性肝细胞癌（即代谢性肝细胞癌）的逐渐扩大;（iv）非病毒性肝细胞癌（即代谢性肝细胞癌）的逐渐扩大。（iii）在正确的治疗期间诊断出的肝细胞癌的比例增加（每半年）监测方案;（iv）有利的癌症阶段迁移;（v）增加使用射频消融术，损害经皮乙醇注射;（六）改善消融和经动脉治疗的结果;（七）提高总生存率（调整调查患者的前置时间），特别是在2009年后，病毒和非病毒患者提出的早期或中期hepatocellular carcinoma. Conclusions在过去的15 years几个病因和临床特征的肝细胞癌患者已经改变，作为他们的管理。观察到的总生存率的改善是由于更广泛地使用半年一次的监测，扩大了有资格接受治愈性治疗的肿瘤的比例，以及局部区域治疗的结果得到改善。
Background & AimsEpidemiology of hepatocellular carcinoma is changing worldwide. This study aimed at evaluating the changing scenario of aetiology, presentation, management and prognosis of hepatocellular carcinoma in Italy during the last 15years.MethodsRetrospective analysis of the ITA.LI.CA (Italian Liver Cancer) database including 5192 hepatocellular carcinoma patients managed in 24 centres from 2000 to 2014. Patients were divided into three groups according to the date of cancer diagnosis (2000-2004, 2005-2009 and 2010-2014).ResultsThe main results were as follows: (i) progressive patient aging; (ii) progressive expansion of non-viral cases and, namely, of metabolic hepatocellular carcinomas; (iii) increasing proportion of hepatocellular carcinoma diagnosed during a correct (semi-annual) surveillance programme; (iv) favourable cancer stage migration; (v) increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) improved overall survival (adjusted for the lead time in surveyed patients), particularly after 2009, of both viral and non-viral patients presenting with an early- or intermediate-stage hepatocellular carcinoma.ConclusionsDuring the last 15years several aetiological and clinical features of hepatocellular carcinoma patients have changed, as their management. The observed improvement of overall survival was owing both to the wider use of semi-annual surveillance, expanding the proportion of tumours that qualified for curative treatments, and to the improved outcome of loco-regional treatments.