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Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma

AIM: To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) and to ascertain the factors predicting the achievement of disease control (DC). METHODS: The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt...

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Autores principales: Ponziani, Francesca Romana, Spinelli, Irene, Rinninella, Emanuele, Cerrito, Lucia, Saviano, Antonio, Avolio, Alfonso Wolfango, Basso, Michele, Miele, Luca, Riccardi, Laura, Zocco, Maria Assunta, Annicchiarico, Brigida Eleonora, Garcovich, Matteo, Biolato, Marco, Marrone, Giuseppe, De Gaetano, Anna Maria, Iezzi, Roberto, Giuliante, Felice, Vecchio, Fabio Maria, Agnes, Salvatore, Addolorato, Giovanni, Siciliano, Massimo, Rapaccini, Gian Lodovico, Grieco, Antonio, Gasbarrini, Antonio, Pompili, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756721/
https://www.ncbi.nlm.nih.gov/pubmed/29359015
http://dx.doi.org/10.4254/wjh.v9.i36.1322
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author Ponziani, Francesca Romana
Spinelli, Irene
Rinninella, Emanuele
Cerrito, Lucia
Saviano, Antonio
Avolio, Alfonso Wolfango
Basso, Michele
Miele, Luca
Riccardi, Laura
Zocco, Maria Assunta
Annicchiarico, Brigida Eleonora
Garcovich, Matteo
Biolato, Marco
Marrone, Giuseppe
De Gaetano, Anna Maria
Iezzi, Roberto
Giuliante, Felice
Vecchio, Fabio Maria
Agnes, Salvatore
Addolorato, Giovanni
Siciliano, Massimo
Rapaccini, Gian Lodovico
Grieco, Antonio
Gasbarrini, Antonio
Pompili, Maurizio
author_facet Ponziani, Francesca Romana
Spinelli, Irene
Rinninella, Emanuele
Cerrito, Lucia
Saviano, Antonio
Avolio, Alfonso Wolfango
Basso, Michele
Miele, Luca
Riccardi, Laura
Zocco, Maria Assunta
Annicchiarico, Brigida Eleonora
Garcovich, Matteo
Biolato, Marco
Marrone, Giuseppe
De Gaetano, Anna Maria
Iezzi, Roberto
Giuliante, Felice
Vecchio, Fabio Maria
Agnes, Salvatore
Addolorato, Giovanni
Siciliano, Massimo
Rapaccini, Gian Lodovico
Grieco, Antonio
Gasbarrini, Antonio
Pompili, Maurizio
author_sort Ponziani, Francesca Romana
collection PubMed
description AIM: To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) and to ascertain the factors predicting the achievement of disease control (DC). METHODS: The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS: One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo (95%CI: 10.6-17.0). Only alphafetoprotein (AFP) serum level > 200 ng/mL and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up (HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year (HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC (OR = 0.263, 95%CI: 0.111-0.622, P = 0.002). CONCLUSION: The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients’ survival confers them as useful predictive tools for treatment management and clinical decisions.
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spelling pubmed-57567212018-01-22 Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma Ponziani, Francesca Romana Spinelli, Irene Rinninella, Emanuele Cerrito, Lucia Saviano, Antonio Avolio, Alfonso Wolfango Basso, Michele Miele, Luca Riccardi, Laura Zocco, Maria Assunta Annicchiarico, Brigida Eleonora Garcovich, Matteo Biolato, Marco Marrone, Giuseppe De Gaetano, Anna Maria Iezzi, Roberto Giuliante, Felice Vecchio, Fabio Maria Agnes, Salvatore Addolorato, Giovanni Siciliano, Massimo Rapaccini, Gian Lodovico Grieco, Antonio Gasbarrini, Antonio Pompili, Maurizio World J Hepatol Retrospective Cohort Study AIM: To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) and to ascertain the factors predicting the achievement of disease control (DC). METHODS: The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS: One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo (95%CI: 10.6-17.0). Only alphafetoprotein (AFP) serum level > 200 ng/mL and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up (HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year (HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC (OR = 0.263, 95%CI: 0.111-0.622, P = 0.002). CONCLUSION: The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients’ survival confers them as useful predictive tools for treatment management and clinical decisions. Baishideng Publishing Group Inc 2017-12-28 2017-12-28 /pmc/articles/PMC5756721/ /pubmed/29359015 http://dx.doi.org/10.4254/wjh.v9.i36.1322 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Ponziani, Francesca Romana
Spinelli, Irene
Rinninella, Emanuele
Cerrito, Lucia
Saviano, Antonio
Avolio, Alfonso Wolfango
Basso, Michele
Miele, Luca
Riccardi, Laura
Zocco, Maria Assunta
Annicchiarico, Brigida Eleonora
Garcovich, Matteo
Biolato, Marco
Marrone, Giuseppe
De Gaetano, Anna Maria
Iezzi, Roberto
Giuliante, Felice
Vecchio, Fabio Maria
Agnes, Salvatore
Addolorato, Giovanni
Siciliano, Massimo
Rapaccini, Gian Lodovico
Grieco, Antonio
Gasbarrini, Antonio
Pompili, Maurizio
Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title_full Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title_fullStr Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title_full_unstemmed Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title_short Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma
title_sort reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with barcelona clinic liver cancer stage c hepatocellular carcinoma
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756721/
https://www.ncbi.nlm.nih.gov/pubmed/29359015
http://dx.doi.org/10.4254/wjh.v9.i36.1322
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