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1. Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Author

Riggio, O, Celsa, C, Calvaruso, V, Merli, M, Caraceni, P, Montagnese, S, Mora, V, Milana, M, Saracco, G, Raimondo, G, Benedetti, A, Burra, P, Sacco, R, Persico, M, Schepis, F, Villa, E, Colecchia, A, Fagiuoli, S, Pirisi, M, Barone, M, Azzaroli, F, Soardo, G, Russello, M, Morisco, F, Labanca, S, Fracanzani, A, Pietrangelo, A, Di Maria, G, Nardelli, S, Ridola, L, Gasbarrini, A, Camma, C, Riggio O., Celsa C., Calvaruso V., Merli M., Caraceni P., Montagnese S., Mora V., Milana M., Saracco G. M., Raimondo G., Benedetti A., Burra P., Sacco R., Persico M., Schepis F., Villa E., Colecchia A., Fagiuoli S., Pirisi M., Barone M., Azzaroli F., Soardo G., Russello M., Morisco F., Labanca S., Fracanzani A. L., Pietrangelo A., Di Maria G., Nardelli S., Ridola L., Gasbarrini A., Camma C., Riggio, O, Celsa, C, Calvaruso, V, Merli, M, Caraceni, P, Montagnese, S, Mora, V, Milana, M, Saracco, G, Raimondo, G, Benedetti, A, Burra, P, Sacco, R, Persico, M, Schepis, F, Villa, E, Colecchia, A, Fagiuoli, S, Pirisi, M, Barone, M, Azzaroli, F, Soardo, G, Russello, M, Morisco, F, Labanca, S, Fracanzani, A, Pietrangelo, A, Di Maria, G, Nardelli, S, Ridola, L, Gasbarrini, A, Camma, C, Riggio O., Celsa C., Calvaruso V., Merli M., Caraceni P., Montagnese S., Mora V., Milana M., Saracco G. M., Raimondo G., Benedetti A., Burra P., Sacco R., Persico M., Schepis F., Villa E., Colecchia A., Fagiuoli S., Pirisi M., Barone M., Azzaroli F., Soardo G., Russello M., Morisco F., Labanca S., Fracanzani A. L., Pietrangelo A., Di Maria G., Nardelli S., Ridola L., Gasbarrini A., and Camma C.

Abstract

Introduction: Hepatic encephalopathy (HE) affects the survival and quality of life of patients with cirrhosis. However, longitudinal data on the clinical course after hospitalization for HE are lacking. The aim was to estimate mortality and risk for hospital readmission of cirrhotic patients hospitalized for HE. Methods: We prospectively enrolled 112 consecutive cirrhotic patients hospitalized for HE (HE group) at 25 Italian referral centers. A cohort of 256 patients hospitalized for decompensated cirrhosis without HE served as controls (no HE group). After hospitalization for HE, patients were followed-up for 12 months until death or liver transplant (LT). Results: During follow-up, 34 patients (30.4%) died and 15 patients (13.4%) underwent LT in the HE group, while 60 patients (23.4%) died and 50 patients (19.5%) underwent LT in the no HE group. In the whole cohort, age (HR 1.03, 95% CI 1.01–1.06), HE (HR 1.67, 95% CI 1.08–2.56), ascites (HR 2.56, 95% CI 1.55–4.23), and sodium levels (HR 0.94, 95% CI 0.90–0.99) were significant risk factors for mortality. In the HE group, ascites (HR 5.07, 95% CI 1.39–18.49) and BMI (HR 0.86, 95% CI 0.75–0.98) were risk factors for mortality, and HE recurrence was the first cause of hospital readmission. Conclusion: In patients hospitalized for decompensated cirrhosis, HE is an independent risk factor for mortality and the most common cause of hospital readmission compared with other decompensation events. Patients hospitalized for HE should be evaluated as candidates for LT.

Published
2023

2. Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents

Author

Craxì, A., Di Marco, V., Cammà, C., Calvaruso, V., Petta, S., Cabbibbo, G., Colletti, P., Mazzola, G., Cascio, A., Montalto, G., Licata, A., Giannitrapani, L., Prestileo, T., Di Lorenzo, F., Sanfilippo, A., Ficalora, A., Madonia, S., Tinè, F., Malizia, G., Latteri, F., Maida, M., Cartabellotta, F., Vassallo, R., Cacciola, I., Caccamo, G., Maimone, S., Saitta, C., Squadrito, G., Raimondo, G., Mondello, L., Smedile, A., D’Andrea, S., Bertino, G., Ardiri, A.L., Frazzetto, E., Rigano, G., Montineri, A., Larocca, L.N., Cacopardo, B., Benanti, F., Russello, M., Benigno, R., Bellia, A., Iacobello, C., Davì, A., Di Rosolini, M.A., Digiacomo, A., Fuduli, G., Scifo, G., Distefano, M., Portelli, V., Savalli, F., Scalici, I., Gioia, G., Magro, A., Alaimo, G., Alinovi, M.R., Salvo, A., Averna, A., Lomonaco, F., Guarneri, L., Maffeo, F., Falzone, E., Pulvirenti, F., Calvaruso, Vincenza, Cabibbo, Giuseppe, Cacciola, Irene, Petta, Salvatore, Madonia, Salvatore, Bellia, Alessandro, Tinè, Fabio, Distefano, Marco, Licata, Anna, Giannitrapani, Lydia, Prestileo, Tullio, Mazzola, Giovanni, Di Rosolini, Maria Antonietta, Larocca, Licia, Bertino, Gaetano, Digiacomo, Antonio, Benanti, Francesco, Guarneri, Luigi, Averna, Alfonso, Iacobello, Carmelo, Magro, Antonio, Scalisi, Ignazio, Cartabellotta, Fabio, Savalli, Francesca, Barbara, Marco, Davì, Antonio, Russello, Maurizio, Scifo, Gaetano, Squadrito, Giovanni, Cammà, Calogero, Raimondo, Giovanni, Craxì, Antonio, and Di Marco, Vito

Published
2018
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3. OC.08.4 RISK FACTORS FOR VIRAL REACTIVATION IN PATIENTS WITH OVERT OR OCCULT HEPATITIS B VIRUS INFECTION RECEIVING IMMUNOSUPPRESSIVE TREATMENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author

Rizzo, G.E.M., primary, Celsa, C., additional, Enea, M., additional, Rancatore, G., additional, Graceffa, P., additional, Falco, G., additional, Rizzo, C., additional, Destro Castaniti, G., additional, Madonia, G., additional, Di Stefano, V., additional, Tilotta, G., additional, Agliastro, G., additional, Vaccaro, M., additional, Di Maria, G., additional, Calvaruso, V., additional, Camma, C., additional, and Di Marco, V., additional

Published
2023
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4. OC.12.2 RESIST CRITERIA: A BIOCHEMICAL ALGORITHM TO REDUCE THE NUMBER OF UNNECESSARY UPPER ENDOSCOPIES FOR THE EVALUATION OF PORTAL HYPERTENSION IN COMPENSATED HBVCIRRHOTIC PATIENTS

Author

Calvaruso, V., primary, Celsa, C., additional, Degasperi, E., additional, Di Maria, G., additional, Fichera, A., additional, Graceffa, P., additional, Rancatore, G., additional, Falco, G., additional, Di Martino, V., additional, Rizzo, G.E.M., additional, Grasso, M., additional, Simone, F., additional, Anolli, M., additional, Lampertico, P., additional, Craxi, A., additional, Di Marco, V., additional, and Camma, C., additional

Published
2023
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5. OC.08.2 NETWORK META-ANALYSIS OF FIRST-LINE SYSTEMIC THERAPIES FOR ADVANCED HEPATOCELLULAR CARCINOMA: WHO IS THE WINNER?

Author

Celsa, C., primary, Cabibbo, G., additional, Rizzo, G.E.M., additional, Giuffrida, P., additional, Di Maria, G., additional, Battaglia, S., additional, Vaccaro, M., additional, Enea, M., additional, Giacchetto, C., additional, Rancatore, G., additional, Grassini, M., additional, Ciccia, R., additional, Grova, A., additional, Salvato, M., additional, and Camma, C., additional

Published
2023
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7. OC.08.1 PROGRAMMED CELL DEATH 1 GENETIC VARIANT AND LIVER DAMAGE IN NONALCOHOLIC FATTY LIVER DISEASE

Author

Pipitone, R.M., primary, Malvestiti, F., additional, Pennisi, G., additional, Jamialahmadi, O., additional, Dongiovanni, P., additional, Bertolazzi, G., additional, Pihlajamaki, J., additional, Yki-Jarvinen, H., additional, Vespasiani-Gentilucci, U., additional, Tavaglione, F., additional, Maurotti, S., additional, Bianco, C., additional, Di Maria, G., additional, Enea, M., additional, Fracanzani, A., additional, Karja, V., additional, Lupo, G., additional, Mannisto, V., additional, Meroni, M., additional, Piciotti, R., additional, Qadri, S., additional, Zito, R., additional, Craxi, A., additional, Di Marco, V., additional, Camma, C., additional, Tripodo, C., additional, Valenti, L., additional, Romeo, S., additional, Petta, S., additional, and Grimaudo, S., additional

Published
2023
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8. Corrigendum to 'Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)' Nutrition, Metabolism and Cardiovascular diseases volume 32 issue 1 (2022) 1-16

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

N/A

Published
2023

9. Corrigendum to 'Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)' [Dig Liver Dis 54 (2022) 170-182]

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

N/A

Published
2023

11. Pattern of macrovascular invasion in hepatocellular carcinoma

Author

Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., Romagnoli, V., Guarino M., Cucchetti A., Pontillo G., Farinati F., Benevento F., Rapaccini G.L., Di Marco M., Caturelli E., Zoli M., Rodolfo S., Cabibbo G., Marra F., Mega A., Gasbarrini A., Svegliati-Baroni G., Foschi F.G., Missale G., Masotto A., Nardone G., Raimondo G., Azzaroli F., Vidili G., Oliveri F., Trevisani F., Giannini E.G., Morisco F., Biselli M., Caraceni P., Garuti F., Gramenzi A., Neri A., Rampoldi D., Santi V., Forgione A., Granito A., Muratori L., Piscaglia F., Sansone V., Tovoli F., Dajti E., Marasco G., Ravaioli F., Cappelli A., Golfieri R., Mosconi C., Renzulli M., Cela E.M., Facciorusso A., Pelizzaro F., Imondi A., Sartori A., Penzo B., Cacciato V., Casagrande E., Moscatelli A., Pellegatta G., Pieri G., de Matthaeis N., Allegrini G., Lauria V., Ghittoni G., Pelecca G., Chegai F., Coratella F., Ortenzi M., Olivari A., Inno A., Marchetti F., Busacca A., Camma C., Di Martino V., Rizzo G.E.M., Franze M.S., Saitta C., Sauchella A., Bevilacqua V., Borghi A., Gardini A.C., Conti F., Berardinelli D., Ercolani G., Napoli L., Campani C., Di Bonaventura C., Gitto S., Coccoli P., Malerba A., Capasso M., Fiorentino A., Pignata L., Cossiga V., Romagnoli V., Guarino, M., Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, G. L., Di Marco, M., Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, A., Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, A., Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., de Matthaeis, N., Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, M., Fiorentino, A., Pignata, L., Cossiga, V., and Romagnoli, V.

Subjects
Ablation Techniques, Male, Registrie, Cirrhosis, Clinical Biochemistry, Mesenteric Vein, loco-regional treatment, 030204 cardiovascular system & hematology, Biochemistry, Gastroenterology, surgery, Antineoplastic Agent, Liver disease, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, cirrhosis, hepatocellular carcinoma, portal vein thrombosis, transplantation, Ascites, Ablation Technique, Registries, 030212 general & internal medicine, Chronic, Settore MED/12 - Gastroenterologia, Portal Vein, Liver Diseases, Liver Neoplasms, General Medicine, Middle Aged, Sorafenib, Prognosis, Hepatitis B, Alcoholic, Hepatitis C, Tumor Burden, Survival Rate, Italy, Liver Neoplasm, Hepatocellular carcinoma, Ascite, Female, medicine.symptom, Liver cancer, Human, medicine.medical_specialty, Carcinoma, Hepatocellular, Prognosi, Antineoplastic Agents, End Stage Liver Disease, 03 medical and health sciences, Mesenteric Veins, Hepatitis B, Chronic, Internal medicine, medicine, Humans, Hepatectomy, Neoplasm Invasiveness, portal vein thrombosi, Liver Diseases, Alcoholic, Aged, Neoplasm Invasivene, Performance status, business.industry, Carcinoma, Settore MED/09 - MEDICINA INTERNA, Patient Acuity, Hepatocellular, Hepatitis C, Chronic, medicine.disease, Liver Transplantation, Transplantation, Liver function, business, cirrhosi
Abstract

Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008-2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter-relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0months (95% CI, 5.1-7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4months in those with PS>1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1months in patients with PS 0-1, no ascites and Vp1-Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions.

Published
2021
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12. Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Federici M., Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), and Federici M.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common and emerging liver disease in adults, paralleling the epidemic of obesity and diabetes, and leading to worrisome events (hepatocellular carcinoma and end-stage liver disease). In the last years, mounting evidence added insights about epidemiology, natural history, diagnosis and lifestyle-based or drug treatment of NAFLD. In this rapidly evolving scenario, members of the Associazione Italiana per lo Studio del Fegato (AISF), the Società Italiana di Diabetologia (SID) and the Società Italiana dell'Obesità (SIO) reviewed current knowledge on NAFLD. The quality of the published evidence is graded, and practical recommendations are made following the rules and the methodology suggested in Italy by the Centro Nazionale per l'Eccellenza delle cure (CNEC) and Istituto Superiore di Sanità (ISS). Whenever possible, recommendations are placed within the context the Italian Healthcare system, with reference to specific experience and local diagnostic and management resources. Level of evidence: Level of evidence of recommendations for each PICO question were reported according to available evidence.

Published
2022

15. OC-10Liver-related and extrahepatic events occurrence in patients with nonalcoholic fatty liver disease: a competing risk analysis

Author

Pennisi, G., primary, Enea, M., additional, Romero-Gomez, M., additional, Viganò, M., additional, Bugianesi, E., additional, Wong, V.W., additional, Fracanzani, A.L., additional, Sebastiani, G., additional, Boursier, J., additional, Berzigotti, A., additional, Eslam, M., additional, Ampuero, J., additional, Benmassaoud, A., additional, Mendoza, Y.P., additional, George, J., additional, Craxì, A., additional, Camma, C., additional, de Ledinghen, V., additional, and Petta, S., additional

Published
2021
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17. Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Federici M., Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), and Federici M.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common and emerging liver disease in adults, paralleling the epidemic of obesity and diabetes and leading to worrisome events (hepatocellular carcinoma and end-stage liver disease). In the past years, mounting evidence added insights about epidemiology, natural history, diagnosis and lifestyle-based or drug treatment of NAFLD. In this rapidly evolving scenario, members of the Associazione Italiana per lo Studio del Fegato, the Società Italiana di Diabetologia and the Società Italiana dell’Obesità reviewed current knowledge on NAFLD. The quality of the published evidence is graded, and practical recommendations are made following the rules and the methodology suggested in Italy by the Centro Nazionale per l’Eccellenza delle cure and Istituto Superiore di Sanità. Whenever possible, recommendations are placed within the context the Italian Healthcare system, with reference to specific experience and local diagnostic and management resources. Level of evidence Level of evidence of recommendations for each PICO question were reported according to available evidence.

Published
2021

18. Predicting in-hospital mortality from Coronavirus Disease 2019: A simple validated app for clinical use

Author

Magro, B., Zuccaro, V., Novelli, L., Zileri, L., Celsa, C., Raimondi, F., Gori, Mario, Camma, Giulia, Battaglia, Laura Silvia Carmen Irene, Genova, V. G., Paris, Leonardo, Tacelli, M., Mancarella, Francesco Antonio, Enea, M., Attanasio, M., Senni, M., Marco, F. D., Lorini, L. F., Fagiuoli, Stefano, Bruno, Rosa Anna, Camma, C., Gasbarrini, Antonio, Gori M., Camma G., Battaglia S., Paris L., Mancarella F. A., Fagiuoli S., Bruno R., Gasbarrini A. (ORCID:0000-0002-7278-4823), Magro, B., Zuccaro, V., Novelli, L., Zileri, L., Celsa, C., Raimondi, F., Gori, Mario, Camma, Giulia, Battaglia, Laura Silvia Carmen Irene, Genova, V. G., Paris, Leonardo, Tacelli, M., Mancarella, Francesco Antonio, Enea, M., Attanasio, M., Senni, M., Marco, F. D., Lorini, L. F., Fagiuoli, Stefano, Bruno, Rosa Anna, Camma, C., Gasbarrini, Antonio, Gori M., Camma G., Battaglia S., Paris L., Mancarella F. A., Fagiuoli S., Bruno R., and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

Backgrounds Validated tools for predicting individual in-hospital mortality of COVID-19 are lacking. We aimed to develop and to validate a simple clinical prediction rule for early identification of in-hospital mortality of patients with COVID-19. Methods and findings We enrolled 2191 consecutive hospitalized patients with COVID-19 from three Italian dedicated units (derivation cohort: 1810 consecutive patients from Bergamo and Pavia units; validation cohort: 381 consecutive patients from Rome unit). The outcome was in-hospital mortality. Fine and Gray competing risks multivariate model (with discharge as a competing event) was used to develop a prediction rule for in-hospital mortality. Discrimination and calibration were assessed by the area under the receiver operating characteristic curve (AUC) and by Brier score in both the derivation and validation cohorts. Seven variables were independent risk factors for in-hospital mortality: age (Hazard Ratio [HR] 1.08, 95% Confidence Interval [CI] 1.07–1.09), male sex (HR 1.62, 95%CI 1.30–2.00), duration of symptoms before hospital admission <10 days (HR 1.72, 95%CI 1.39–2.12), diabetes (HR 1.21, 95% CI 1.02–1.45), coronary heart disease (HR 1.40 95% CI 1.09–1.80), chronic liver disease (HR 1.78, 95%CI 1.16–2.72), and lactate dehydrogenase levels at admission (HR 1.0003, 95%CI 1.0002–1.0005). The AUC was 0.822 (95%CI 0.722–0.922) in the derivation cohort and 0.820 (95%CI 0.724–0.920) in the validation cohort with good calibration. The prediction rule is freely available as a web-app (COVID-CALC: https://sites.google.com/community. unipa.it/covid-19riskpredictions/c19-rp). Conclusions A validated simple clinical prediction rule can promptly and accurately assess the risk for in-hospital mortality, improving triage and the management of patients with COVID-19.

Published
2021

19. Pattern of macrovascular invasion in hepatocellular carcinoma

Author

Guarino, Mariateresa, Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, Antonio, Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, Alessandra, Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., De Matthaeis, Nicoletta, Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, Elena Armida, Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, Francesco, Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, Monica, Fiorentino, Alice, Pignata, L., Cossiga, V., Romagnoli, V., Guarino M., Rapaccini G. L. (ORCID:0000-0002-6467-857X), Di Marco M., Gasbarrini A. (ORCID:0000-0002-7278-4823), Forgione A., de Matthaeis N., Olivari A., Conti F., Capasso M., Fiorentino A., Guarino, Mariateresa, Cucchetti, A., Pontillo, G., Farinati, F., Benevento, F., Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, E., Zoli, M., Rodolfo, S., Cabibbo, G., Marra, F., Mega, A., Gasbarrini, Antonio, Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Oliveri, F., Trevisani, F., Giannini, E. G., Morisco, F., Biselli, M., Caraceni, P., Garuti, F., Gramenzi, A., Neri, A., Rampoldi, D., Santi, V., Forgione, Alessandra, Granito, A., Muratori, L., Piscaglia, F., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Pelizzaro, F., Imondi, A., Sartori, A., Penzo, B., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., Pieri, G., De Matthaeis, Nicoletta, Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Olivari, Elena Armida, Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, Francesco, Berardinelli, D., Ercolani, G., Napoli, L., Campani, C., Di Bonaventura, C., Gitto, S., Coccoli, P., Malerba, A., Capasso, Monica, Fiorentino, Alice, Pignata, L., Cossiga, V., Romagnoli, V., Guarino M., Rapaccini G. L. (ORCID:0000-0002-6467-857X), Di Marco M., Gasbarrini A. (ORCID:0000-0002-7278-4823), Forgione A., de Matthaeis N., Olivari A., Conti F., Capasso M., and Fiorentino A.

Abstract

Background and aims: In patients with hepatocellular carcinoma (HCC), macrovascular invasion (MaVI) limits treatment options and decreases survival. Detailed data on the relationship between MaVI extension and patients' characteristics, and its impact on patients' outcome are limited. We evaluated the prevalence and extension of MaVI in a large cohort of consecutive HCC patients, analysing its association with liver disease and tumour characteristics, as well as with treatments performed and patients' survival. Methods: We analysed data of 4774 patients diagnosed with HCC recorded in the Italian Liver Cancer (ITA.LI.CA) database (2008-2018). Recursive partition analysis (RPA) was performed to evaluate interactions between MaVI, clinical variables and treatment, exploring the inter-relationship determining overall survival. Results: MaVI prevalence was 11.1%, and median survival of these patients was 6.0 months (95% CI, 5.1-7.1). MaVI was associated with younger age at diagnosis, presence of symptoms, worse Performance Status (PS) and liver function, high alphafetoprotein levels and large HCCs. MaVI extension was associated with worse PS, ascites and greater impairment in liver function. RPA identified patients' categories with different treatment indications and survival, ranging from 2.4 months in those with PS > 1 and ascites, regardless of MaVI extension (receiving best supportive care in 90.3% of cases), to 14.1 months in patients with PS 0-1, no ascites and Vp1-Vp2 MaVI (treated with surgery in 19.1% of cases). Conclusions: MaVI presence and extension, together with PS and ascites, significantly affect patients' survival and treatment selection. The decision tree based on these parameters may help assess patients' prognosis and inform therapeutic decisions.

Published
2021

20. The changing scenario of hepatocellular carcinoma in Italy: an update

Author

Garuti, F., Neri, A., Avanzato, F., Gramenzi, A., Rampoldi, D., Rucci, P., Farinati, F., Giannini, E. G., Piscaglia, F., Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, E., Zoli, M., Sacco, R., Cabibbo, G., Marra, F., Mega, A., Morisco, F., Gasbarrini, Antonio, Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Brunetto, M. R., Trevisani, F., Biselli, M., Caraceni, P., Santi, V., Granito, A., Muratori, L., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., De Matthaeis, Nicoletta, Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Biasini, E., Olivani, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Berardinelli, D., Borghi, A., Gardini, A. C., Conti, Francesco, Cucchetti, A., Dall'Aglio, A. C., Ercolani, G., Campani, C., Di Bonaventura, C., Gitto, S., Malerba, P. C. A., Capasso, Monica, Guarino, Mariateresa, Oliveri, F., Romagnoli, V., Rapaccini G. L. (ORCID:0000-0002-6467-857X), Di Marco M., Gasbarrini A. (ORCID:0000-0002-7278-4823), de Matthaeis N., Conti F., Capasso M., Guarino M., Garuti, F., Neri, A., Avanzato, F., Gramenzi, A., Rampoldi, D., Rucci, P., Farinati, F., Giannini, E. G., Piscaglia, F., Rapaccini, Gian Ludovico, Di Marco, Maria Teresa, Caturelli, E., Zoli, M., Sacco, R., Cabibbo, G., Marra, F., Mega, A., Morisco, F., Gasbarrini, Antonio, Svegliati-Baroni, G., Foschi, F. G., Missale, G., Masotto, A., Nardone, G., Raimondo, G., Azzaroli, F., Vidili, G., Brunetto, M. R., Trevisani, F., Biselli, M., Caraceni, P., Santi, V., Granito, A., Muratori, L., Sansone, V., Tovoli, F., Dajti, E., Marasco, G., Ravaioli, F., Cappelli, A., Golfieri, R., Mosconi, C., Renzulli, M., Cela, E. M., Facciorusso, A., Cacciato, V., Casagrande, E., Moscatelli, A., Pellegatta, G., De Matthaeis, Nicoletta, Allegrini, G., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Biasini, E., Olivani, A., Inno, A., Marchetti, F., Busacca, A., Camma, C., Di Martino, V., Rizzo, G. E. M., Franze, M. S., Saitta, C., Sauchella, A., Bevilacqua, V., Berardinelli, D., Borghi, A., Gardini, A. C., Conti, Francesco, Cucchetti, A., Dall'Aglio, A. C., Ercolani, G., Campani, C., Di Bonaventura, C., Gitto, S., Malerba, P. C. A., Capasso, Monica, Guarino, Mariateresa, Oliveri, F., Romagnoli, V., Rapaccini G. L. (ORCID:0000-0002-6467-857X), Di Marco M., Gasbarrini A. (ORCID:0000-0002-7278-4823), de Matthaeis N., Conti F., Capasso M., and Guarino M.

Abstract

Background and aims: Epidemiology of hepatocellular carcinoma (HCC) is changing in most areas of the world. This study aimed at updating the changing scenario of aetiology, clinical presentation, management and prognosis of HCC in Italy during the last 15 years. Methods: Retrospective analysis of the Italian Liver Cancer (ITA.LI.CA) database included 6034 HCC patients managed in 23 centres from 2004 to 2018. Patients were divided into three groups according to the date of cancer diagnosis (2004-2008, 2009-2013 and 2014-2018). Results: The main results were: (i) a progressive patient ageing; (ii) a progressive increase of non-viral cases and, particularly, of ‘metabolic’ and ‘metabolic + alcohol’ HCCs; (iii) a slightly decline of cases diagnosed under surveillance, but with an incremental use of the semiannual schedule; (iv) a favourable cancer stage migration; (v) an increased use of radiofrequency ablation to the detriment of percutaneous ethanol injection; (vi) improved outcomes of ablative and transarterial treatments; (vii) an improved overall survival (adjusted for the lead time in surveyed patients) in the last calendar period, particularly in viral patients; (viii) a large gap between the number of potential candidates (according to oncologic criteria and age) to liver transplant and that of transplanted patients. Conclusions: During the last 15 years several aspects of HCC scenario have changed, as well as its management. The improvement in patient survival observed in the last period was likely because of a larger use of thermal ablation with respect to the less effective alcohol injection and to an improved management of intermediate stage patients.

Published
2021

22. Genomic Epidemiology of the First Wave of SARS-CoV-2 in Italy

Author

Di Giallonardo, F, Duchene, S, Puglia, I, Curini, V, Profeta, F, Camma, C, Marcacci, M, Calistri, P, Holmes, EC, Lorusso, A, Di Giallonardo, F, Duchene, S, Puglia, I, Curini, V, Profeta, F, Camma, C, Marcacci, M, Calistri, P, Holmes, EC, and Lorusso, A

Abstract

Italy was one of the first countries to experience a major epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with >1000 cases confirmed by 1 March 2020. However, virus genome sequence data is sparse and there has been only limited investigation of virus transmission across the country. Here, we provide the most extensive study to date of the genomic epidemiology of SARS-CoV-2 in Italy covering the first wave of infection. We generated 191 new full-length genomes, largely sampled from central Italy (Abruzzo), before, during, and after the enforcement of a nationwide "lockdown" (8 March-3 June). These were combined with 460 published SARS-CoV-2 sequences sampled across Italy. Phylogenetic analysis including global sequence data revealed multiple independent introductions into Italy, with at least 124 instances of sequence clusters representing longer chains of transmission. Eighteen of these transmission clusters emerged before the nation-wide lockdown was implemented on 8 March, and an additional 18 had evidence for transmission between different Italian regions. Extended transmission periods between infections of up to 104 days were observed in five clusters. In addition, we found seven clusters that persisted throughout the lockdown period. Overall, we show how importations were an important driver of the first wave of SARS-CoV-2 in Italy.

Published
2020

25. Retreatment with interferon plus ribavirin of chronic hepatitis C non-responders to interferon monotherapy: a meta-analysis of individual patient data. (Liver Disease)

Author

Camma, C., Bruno, S., Schepis, F., Iacono, O. Lo, Andreone, P., Gramenzi, A.G., Mangia, A., Andriulli, A., Puoti, M., Spadaro, A., Freni, M., Marco, V. Di, Cino, L., Saracco, G., Chiesa, A., Crosignani, A., Caporaso, N., Morisco, F., Rumi, M.G., and Craxi, A.

Subjects
Interferon -- Evaluation, Ribavirin -- Evaluation, Hepatitis C -- Drug therapy, Health
Abstract

Background and aims: Retreatment with a combination of α interferon (IFN) plus ribavirin of patients with chronic hepatitis C who did not respond to IFN monotherapy has not been assessed [...]

Published
2002

28. Proficiency testing of virus diagnostics based on bioinformatics analysis of simulated in silico high-throughput sequencing data sets

Author

Brinkmann, A. (Annika), Andrusch, A. (Andreas), Belka, A. (Ariane), Wylezich, C. (Claudia), Höper, D. (Dirk), Pohlmann, A. (Anne), Petersen, T.N. (Thomas Nordahl), Lucas, P. (Pierrick), Blanchard, Y. (Yannick), Papa, A. (Anna), Melidou, A. (Angeliki), Oude Munnink, B.B. (Bas B.), Matthijnssens, J. (Jelle), Deboutte, W. (Ward), Ellis, R.J. (Richard J.), Hansmann, F. (Florian), Baumgärtner, V. (Volkmar), Vries, E. (Erhard) van der, Osterhaus, A. (Albert), Camma, C. (Cesare), Mangone, I. (Iolanda), Lorusso, A. (Alessio), Marcacci, M. (Maurilia), Nunes, A. (Alexandra), Pinto, M. (Miguel), Borges, V. (Vítor), Kroneman, A. (Annelies), Schmitz, D. (Dennis), Corman, V.M. (Victor), Drosten, C. (Christian), Jones, T. (Terry), Hendriksen, R.S. (Rene S.), Aarestrup, F.M. (Frank), Koopmans D.V.M., M.P.G. (Marion), Beer, M. (Martin), Nitsche, A., Brinkmann, A. (Annika), Andrusch, A. (Andreas), Belka, A. (Ariane), Wylezich, C. (Claudia), Höper, D. (Dirk), Pohlmann, A. (Anne), Petersen, T.N. (Thomas Nordahl), Lucas, P. (Pierrick), Blanchard, Y. (Yannick), Papa, A. (Anna), Melidou, A. (Angeliki), Oude Munnink, B.B. (Bas B.), Matthijnssens, J. (Jelle), Deboutte, W. (Ward), Ellis, R.J. (Richard J.), Hansmann, F. (Florian), Baumgärtner, V. (Volkmar), Vries, E. (Erhard) van der, Osterhaus, A. (Albert), Camma, C. (Cesare), Mangone, I. (Iolanda), Lorusso, A. (Alessio), Marcacci, M. (Maurilia), Nunes, A. (Alexandra), Pinto, M. (Miguel), Borges, V. (Vítor), Kroneman, A. (Annelies), Schmitz, D. (Dennis), Corman, V.M. (Victor), Drosten, C. (Christian), Jones, T. (Terry), Hendriksen, R.S. (Rene S.), Aarestrup, F.M. (Frank), Koopmans D.V.M., M.P.G. (Marion), Beer, M. (Martin), and Nitsche, A.

Abstract

Quality management and independent assessment of high-throughput sequencing-based virus diagnostics have not yet been established as a mandatory approach for ensuring comparable results. The sensitivity and specificity of viral high-throughput sequence data analysis are highly affected by bioinformatics processing using publicly available and custom tools and databases and thus differ widely between individuals and institutions. Here we present the results of the COMPARE [Collaborative Management Platform for Detection and Analyses of (Re-) emerging and Foodborne Outbreaks in Europe] in silico virus proficiency test. An artificial, simulated in silico data set of Illumina HiSeq sequences was provided to 13 different European institutes for bioinformatics analysis to identify viral pathogens in high-throughput sequence data. Comparison of the participants’ analyses shows that the use of different tools, programs, and databases for bioinformatics analyses can impact the correct identification of viral sequences from a simple data set. The identification of slightly mutated and highly divergent virus genomes has been shown to be most challenging. Furthermore, the interpretation of the results, together with a fictitious case report, by the participants showed that in addition to the bioinformatics analysis, the virological evaluation of the results can be important in clinical settings. External quality assessment and proficiency testing should become an important part of validating high-throughput sequencing-based virus diagnostics and could improve the harmonization, comparability, and reproducibility of results. There is a need for the establishment of international proficiency testing, like that established for conventional laboratory tests such as PCR, for bioinformatics pipelines and the interpretation of such results.

Published
2019
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29. Proficiency Testing of Virus Diagnostics Based on Bioinformatics Analysis of Simulated In Silico High-Throughput Sequencing Data Sets

Author

Brinkmann, AO, Andrusch, A, Belka, A, Wylezich, C, Hoper, D, Pohlmann, A, Petersen, TN, Lucas, P, Blanchard, Y, Papa, A, Melidou, A, Oude Munnink, Bas, Matthijnssens, J, Deboutte, W, Ellis, RJ, Hansmann, F, Baumgartner, W, Vries, Esther, Osterhaus, A, Camma, C, Mangone, I, Lorusso, A, Marcacci, M, Nunes, A, Pinto, M, Borges, V, Kroneman, A, Schmitz, Dennis, Corman, VM, Drosten, C, Jones, TC, Hendriksen, RS, Aarestrup, FM, Koopmans, Marion, Beer, M, Nitsche, A, Brinkmann, AO, Andrusch, A, Belka, A, Wylezich, C, Hoper, D, Pohlmann, A, Petersen, TN, Lucas, P, Blanchard, Y, Papa, A, Melidou, A, Oude Munnink, Bas, Matthijnssens, J, Deboutte, W, Ellis, RJ, Hansmann, F, Baumgartner, W, Vries, Esther, Osterhaus, A, Camma, C, Mangone, I, Lorusso, A, Marcacci, M, Nunes, A, Pinto, M, Borges, V, Kroneman, A, Schmitz, Dennis, Corman, VM, Drosten, C, Jones, TC, Hendriksen, RS, Aarestrup, FM, Koopmans, Marion, Beer, M, and Nitsche, A

Published
2019

39. Refining sorafenib therapy: Lessons from clinical practice

Author

Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, Colombo, M, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G. G., Fagiuoli S., Camma C., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., Colombo M., Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, Colombo, M, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G. G., Fagiuoli S., Camma C., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., and Colombo M.

Abstract

Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.

Published
2015

46. Hepatitis C Virus eradication by direct antiviral agents improves carotid atherosclerosis in patients with advanced fibrosis/compensated cirrhosis

Author

Petta, S., primary, Adinolfi, L.E., additional, Fracanzani, A.L., additional, Calvaruso, V., additional, Rini, F., additional, Camma, C., additional, Marco, V.D., additional, Giordano, M., additional, Marrone, A., additional, Nevola, R., additional, Pinto, A., additional, Rinaldi, L., additional, Torres, D., additional, Tuttolomondo, A., additional, Valenti, L., additional, Fargion, S., additional, and Craxi, A., additional

Published
2018
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47. Noninvasvie prediction of oesophageal varics by liver stiffness measurement and platelet values in patients with liver cirrhosis due to nonalcoholic fatty liver disease: A multicenter cross-sectional study

Author

Petta, S., primary, Sebastiani, G., additional, Bugianesi, E., additional, Viganò, M., additional, Sun, W., additional, Wong, V., additional, Berzigotti, A., additional, Fracanzani, A.L., additional, Anstee, Q., additional, Marra, F., additional, Barbara, M., additional, Calvaruso, V., additional, Camma, C., additional, Di Marco, V., additional, Lombardi, R., additional, Rumi, M.G., additional, Craxi, A., additional, and De Ledinghen, V., additional

Published
2018
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48. Disease outcomes after DAA-induced SVR: data from the resist-HCV cohort

Author

Calvaruso, V., primary, Petta, S., additional, Cacciola, I., additional, Cabibbo, G., additional, Fabio, C., additional, DI Rosolini, M.A., additional, Davì, A., additional, Cannavò, M.R., additional, Russello, M., additional, Di Stefano, M., additional, Scifo, G., additional, DI Lorenzo, F., additional, Tullio, P., additional, Larocca, L.N., additional, Montineri, A., additional, Fuduli, G., additional, DI Giacomo, A., additional, Cannizzaro, M., additional, Madonia, S., additional, Licata, A., additional, Malizia, G., additional, Alaimo, G., additional, Bertino, G., additional, Cacopardo, B., additional, Iacobello, C., additional, Averna, A., additional, Guarneri, L., additional, Scalisi, I., additional, Mazzola, G., additional, Mondello, L., additional, Vincenzo, P., additional, Squadrito, G., additional, Camma, C., additional, Raimondo, G., additional, Craxi, A., additional, and DI Marco, V., additional

Published
2018
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49. Is early recurrence of hepatocellular carcinoma in HCV cirrhotic patients affected by treatment with direct-acting antivirals? A prospective multicentre study

Author

Cabibbo, G., Petta, S., Calvaruso, V., Cacciola, I., Cannavo, M. R., Madonia, S., Distefano, Maria Grazia, Larocca, Luigi Maria, Prestileo, T., Tine, F., Bertino, G., Giannitrapani, L., Benanti, F., Licata, Maria Angela Vittoria Anna Chiara, Scalisi, I., Mazzola, G., Cartabellotta, F., Alessi, N., Barbara, M., Russello, M., Scifo, G., Squadrito, G., Raimondo, G., Craxi, A., Di Marco, V., Camma, C., Colletti, P., Corrao, S., Di Lorenzo, F., Fecarotta, R., Sanfilippo, P., Malizia, G., Latteri, F., Maida, M., Vassallo, R., Caccamo, G., Maimone, S., Saitta, C., Mondello, L., Smedile, A., Ardiri, A. L., Montineri, A., Larocca, L. N., Cacopardo, Beatrice Marina, Benigno, R., Bellia, A., Iacobello, C., Davi, A., Di Rosolini, M. A., Digiacomo, A., Fuduli, G., Portelli, V., Savalli, F., Scalici, I., Gioia, G., Magro, A., Alaimo, G., Salvo, A., Averna, A., Lomonaco, F., Quattrocchi, U., Guarneri, L., Maffeo, F., Distefano M., Larocca L. (ORCID:0000-0003-1739-4758), Licata A., Cacopardo B., Cabibbo, G., Petta, S., Calvaruso, V., Cacciola, I., Cannavo, M. R., Madonia, S., Distefano, Maria Grazia, Larocca, Luigi Maria, Prestileo, T., Tine, F., Bertino, G., Giannitrapani, L., Benanti, F., Licata, Maria Angela Vittoria Anna Chiara, Scalisi, I., Mazzola, G., Cartabellotta, F., Alessi, N., Barbara, M., Russello, M., Scifo, G., Squadrito, G., Raimondo, G., Craxi, A., Di Marco, V., Camma, C., Colletti, P., Corrao, S., Di Lorenzo, F., Fecarotta, R., Sanfilippo, P., Malizia, G., Latteri, F., Maida, M., Vassallo, R., Caccamo, G., Maimone, S., Saitta, C., Mondello, L., Smedile, A., Ardiri, A. L., Montineri, A., Larocca, L. N., Cacopardo, Beatrice Marina, Benigno, R., Bellia, A., Iacobello, C., Davi, A., Di Rosolini, M. A., Digiacomo, A., Fuduli, G., Portelli, V., Savalli, F., Scalici, I., Gioia, G., Magro, A., Alaimo, G., Salvo, A., Averna, A., Lomonaco, F., Quattrocchi, U., Guarneri, L., Maffeo, F., Distefano M., Larocca L. (ORCID:0000-0003-1739-4758), Licata A., and Cacopardo B.

Abstract

Background: Data on HCV-related hepatocellular carcinoma (HCC) early recurrence in patients whose HCC was previously cured, and subsequently treated by direct-acting antivirals (DAAs), are equivocal. Aim: To assess the risk of HCC early recurrence after DAAs exposure in a large prospective cohort of HCV-cirrhotic patients with previous successfully treated HCC, also looking for risk factors for cancer early recurrence. Methods: We enrolled 143 consecutive patients with complete response after curative treatment of HCC, subsequently treated with DAAs and monitored by the web-based RESIST-HCV database. Clinical, biological, and virological data were collected. The primary endpoint was the probability of HCC early recurrence from DAA starting by Kaplan-Meier method. Results: Eighty-six per cent of patients were in Child-Pugh class A and 76% of patients were BCLC A. Almost all patients (96%) achieved sustained virological response. Twenty-four HCC recurrences were observed, with nodular or infiltrative pattern in 83% and 17% of patients, respectively. The 6-, 12- and 18-month HCC recurrence rates were 12%, 26.6% and 29.1%, respectively. Main tumour size and history of prior HCC recurrence were independent risk factors for HCC recurrence by Cox multivariate model. Conclusions: Probability of HCC early recurrence in patients who had HCC previously cured remains high, despite HCV eradication by DAAs. Risk was comparable but not higher to that reported in literature in DAA-untreated patients. Previous HCC recurrence and tumour size can be used to stratify the risk of HCC early recurrence. Further studies are needed to assess impact of DAAs on late recurrence and mortality.

Published
2017

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