Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma

Giuseppe Cabibbo, Salvatore Petta, Calogero Camma', Antonio Craxi, Alberto Masotto, Andrea Olivani, Gian Lodovico Rapaccini, Fabio Marra, Antonio Gasbarrini, Maria Di Marco, Francesca Ciccarese, Giulia Negrini, Andrea Mega, Marco Zoli, Gianluca Svegliati-Baroni, Laura Bucci, Francesco Giuseppe Foschi, Roberto Virdone, Luisa Benvegnù, Franco BorzioFilomena Morisco, Antonio Colecchia, Gerardo Nardone, Fabio Farinati, Franco Trevisani, Eugenio Caturelli, Rodolfo Sacco, Edoardo G. Giannini, Marcello Persico, Marco Barbara, Simona Attardo

Risultato della ricerca: Article

34 Citazioni (Scopus)

Abstract

Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12 months of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BCLC stage 0/A HCC who had complete radiological response after curative resection or thermal ablation were prospectively recruited to this study. Primary endpoint of the study was 5-year OS. Independent baseline and time-dependent predictors of 5-year OS were identified by Cox model. Results The observed 5-year survival rate was 44%. The observed HCC early recurrence and early hepatic decompensation rate were 21% and 10%, respectively. Early hepatic decompensation (Hazard Ratio [HR] 7.52; 95% confidence intervals (CI): 1.23â13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23â5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02â2.70) and age (HR 1.04; 95% CI: 1.02â1.07) were significantly associated with the 5-year OS. Conclusion Survival in HCV-infected patients with cirrhosis and successfully treated HCC is influenced by early hepatic decompensation. Our study indirectly suggests that direct-acting antiviral agents could improve OS of HCC patients through long-term preservation of liver function, resulting in a lower cirrhosis-related mortality and a greater change of receiving curative treatments. Lay summary Survival in hepatitis C virus (HCV) infected patients with cirrhosis and successfully treated hepatocellular carcinoma (HCC), is mainly influenced by early hepatic decompensation. HCV eradication after treatment with new direct-acting antiviral agents could improve overall survival of HCC patients through long-term preservation of liver function.
Lingua originaleEnglish
pagine (da-a)65-71
Numero di pagine7
RivistaJournal of Hepatology
Volume67
Stato di pubblicazionePublished - 2017

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Hepacivirus
Hepatocellular Carcinoma
Liver
Fibrosis
Survival
Confidence Intervals
Liver Neoplasms
Recurrence
Antiviral Agents
Esophageal and Gastric Varices
Proportional Hazards Models
Survival Rate
Hot Temperature
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology

Cita questo

Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma. / Cabibbo, Giuseppe; Petta, Salvatore; Camma', Calogero; Craxi, Antonio; Masotto, Alberto; Olivani, Andrea; Rapaccini, Gian Lodovico; Marra, Fabio; Gasbarrini, Antonio; Di Marco, Maria; Ciccarese, Francesca; Negrini, Giulia; Mega, Andrea; Zoli, Marco; Svegliati-Baroni, Gianluca; Bucci, Laura; Foschi, Francesco Giuseppe; Virdone, Roberto; Benvegnù, Luisa; Borzio, Franco; Morisco, Filomena; Colecchia, Antonio; Nardone, Gerardo; Farinati, Fabio; Trevisani, Franco; Caturelli, Eugenio; Sacco, Rodolfo; Giannini, Edoardo G.; Persico, Marcello; Barbara, Marco; Attardo, Simona.

In: Journal of Hepatology, Vol. 67, 2017, pag. 65-71.

Risultato della ricerca: Article

Cabibbo, G, Petta, S, Camma', C, Craxi, A, Masotto, A, Olivani, A, Rapaccini, GL, Marra, F, Gasbarrini, A, Di Marco, M, Ciccarese, F, Negrini, G, Mega, A, Zoli, M, Svegliati-Baroni, G, Bucci, L, Foschi, FG, Virdone, R, Benvegnù, L, Borzio, F, Morisco, F, Colecchia, A, Nardone, G, Farinati, F, Trevisani, F, Caturelli, E, Sacco, R, Giannini, EG, Persico, M, Barbara, M & Attardo, S 2017, 'Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma', Journal of Hepatology, vol. 67, pagg. 65-71.
Cabibbo, Giuseppe ; Petta, Salvatore ; Camma', Calogero ; Craxi, Antonio ; Masotto, Alberto ; Olivani, Andrea ; Rapaccini, Gian Lodovico ; Marra, Fabio ; Gasbarrini, Antonio ; Di Marco, Maria ; Ciccarese, Francesca ; Negrini, Giulia ; Mega, Andrea ; Zoli, Marco ; Svegliati-Baroni, Gianluca ; Bucci, Laura ; Foschi, Francesco Giuseppe ; Virdone, Roberto ; Benvegnù, Luisa ; Borzio, Franco ; Morisco, Filomena ; Colecchia, Antonio ; Nardone, Gerardo ; Farinati, Fabio ; Trevisani, Franco ; Caturelli, Eugenio ; Sacco, Rodolfo ; Giannini, Edoardo G. ; Persico, Marcello ; Barbara, Marco ; Attardo, Simona. / Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma. In: Journal of Hepatology. 2017 ; Vol. 67. pagg. 65-71.
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title = "Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma",
abstract = "Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12{\^A} months of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BCLC stage 0/A HCC who had complete radiological response after curative resection or thermal ablation were prospectively recruited to this study. Primary endpoint of the study was 5-year OS. Independent baseline and time-dependent predictors of 5-year OS were identified by Cox model. Results The observed 5-year survival rate was 44{\%}. The observed HCC early recurrence and early hepatic decompensation rate were 21{\%} and 10{\%}, respectively. Early hepatic decompensation (Hazard Ratio [HR] 7.52; 95{\%} confidence intervals (CI): 1.23{\^a}13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95{\%}CI: 1.23{\^a}5.05), presence of esophageal varices at baseline (HR 1.66; 95{\%} CI: 1.02{\^a}2.70) and age (HR 1.04; 95{\%} CI: 1.02{\^a}1.07) were significantly associated with the 5-year OS. Conclusion Survival in HCV-infected patients with cirrhosis and successfully treated HCC is influenced by early hepatic decompensation. Our study indirectly suggests that direct-acting antiviral agents could improve OS of HCC patients through long-term preservation of liver function, resulting in a lower cirrhosis-related mortality and a greater change of receiving curative treatments. Lay summary Survival in hepatitis C virus (HCV) infected patients with cirrhosis and successfully treated hepatocellular carcinoma (HCC), is mainly influenced by early hepatic decompensation. HCV eradication after treatment with new direct-acting antiviral agents could improve overall survival of HCC patients through long-term preservation of liver function.",
keywords = "Antiviral agents; Carcinoma, hepatocellular; Hepatic decompensation; Hepatitis C; Hepatocellular carcinoma (HCC); Liver cirrhosis; Overall survival; Prognosis; Recurrences; Survival rate; Sustained virological response; Hepatology",
author = "Giuseppe Cabibbo and Salvatore Petta and Calogero Camma' and Antonio Craxi and Alberto Masotto and Andrea Olivani and Rapaccini, {Gian Lodovico} and Fabio Marra and Antonio Gasbarrini and {Di Marco}, Maria and Francesca Ciccarese and Giulia Negrini and Andrea Mega and Marco Zoli and Gianluca Svegliati-Baroni and Laura Bucci and Foschi, {Francesco Giuseppe} and Roberto Virdone and Luisa Benvegn{\`u} and Franco Borzio and Filomena Morisco and Antonio Colecchia and Gerardo Nardone and Fabio Farinati and Franco Trevisani and Eugenio Caturelli and Rodolfo Sacco and Giannini, {Edoardo G.} and Marcello Persico and Marco Barbara and Simona Attardo",
year = "2017",
language = "English",
volume = "67",
pages = "65--71",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",

}

TY - JOUR

T1 - Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma

AU - Cabibbo, Giuseppe

AU - Petta, Salvatore

AU - Camma', Calogero

AU - Craxi, Antonio

AU - Masotto, Alberto

AU - Olivani, Andrea

AU - Rapaccini, Gian Lodovico

AU - Marra, Fabio

AU - Gasbarrini, Antonio

AU - Di Marco, Maria

AU - Ciccarese, Francesca

AU - Negrini, Giulia

AU - Mega, Andrea

AU - Zoli, Marco

AU - Svegliati-Baroni, Gianluca

AU - Bucci, Laura

AU - Foschi, Francesco Giuseppe

AU - Virdone, Roberto

AU - Benvegnù, Luisa

AU - Borzio, Franco

AU - Morisco, Filomena

AU - Colecchia, Antonio

AU - Nardone, Gerardo

AU - Farinati, Fabio

AU - Trevisani, Franco

AU - Caturelli, Eugenio

AU - Sacco, Rodolfo

AU - Giannini, Edoardo G.

AU - Persico, Marcello

AU - Barbara, Marco

AU - Attardo, Simona

PY - 2017

Y1 - 2017

N2 - Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12 months of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BCLC stage 0/A HCC who had complete radiological response after curative resection or thermal ablation were prospectively recruited to this study. Primary endpoint of the study was 5-year OS. Independent baseline and time-dependent predictors of 5-year OS were identified by Cox model. Results The observed 5-year survival rate was 44%. The observed HCC early recurrence and early hepatic decompensation rate were 21% and 10%, respectively. Early hepatic decompensation (Hazard Ratio [HR] 7.52; 95% confidence intervals (CI): 1.23â13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23â5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02â2.70) and age (HR 1.04; 95% CI: 1.02â1.07) were significantly associated with the 5-year OS. Conclusion Survival in HCV-infected patients with cirrhosis and successfully treated HCC is influenced by early hepatic decompensation. Our study indirectly suggests that direct-acting antiviral agents could improve OS of HCC patients through long-term preservation of liver function, resulting in a lower cirrhosis-related mortality and a greater change of receiving curative treatments. Lay summary Survival in hepatitis C virus (HCV) infected patients with cirrhosis and successfully treated hepatocellular carcinoma (HCC), is mainly influenced by early hepatic decompensation. HCV eradication after treatment with new direct-acting antiviral agents could improve overall survival of HCC patients through long-term preservation of liver function.

AB - Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12 months of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BCLC stage 0/A HCC who had complete radiological response after curative resection or thermal ablation were prospectively recruited to this study. Primary endpoint of the study was 5-year OS. Independent baseline and time-dependent predictors of 5-year OS were identified by Cox model. Results The observed 5-year survival rate was 44%. The observed HCC early recurrence and early hepatic decompensation rate were 21% and 10%, respectively. Early hepatic decompensation (Hazard Ratio [HR] 7.52; 95% confidence intervals (CI): 1.23â13.48) and HCC early recurrence as time-dependent covariates (HR 2.50; 95%CI: 1.23â5.05), presence of esophageal varices at baseline (HR 1.66; 95% CI: 1.02â2.70) and age (HR 1.04; 95% CI: 1.02â1.07) were significantly associated with the 5-year OS. Conclusion Survival in HCV-infected patients with cirrhosis and successfully treated HCC is influenced by early hepatic decompensation. Our study indirectly suggests that direct-acting antiviral agents could improve OS of HCC patients through long-term preservation of liver function, resulting in a lower cirrhosis-related mortality and a greater change of receiving curative treatments. Lay summary Survival in hepatitis C virus (HCV) infected patients with cirrhosis and successfully treated hepatocellular carcinoma (HCC), is mainly influenced by early hepatic decompensation. HCV eradication after treatment with new direct-acting antiviral agents could improve overall survival of HCC patients through long-term preservation of liver function.

KW - Antiviral agents; Carcinoma

KW - hepatocellular; Hepatic decompensation; Hepatitis C; Hepatocellular carcinoma (HCC); Liver cirrhosis; Overall survival; Prognosis; Recurrences; Survival rate; Sustained virological response; Hepatology

UR - http://hdl.handle.net/10447/248072

UR - http://www.sciencedirect.com/science/journal/01688278

M3 - Article

VL - 67

SP - 65

EP - 71

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

ER -