Pubblicazioni

Autori:

Vitale, Alessandro; Romano, Pierluigi; Cillo, Umberto; Lauterio, Andrea; Sangiovanni, Angelo; Cabibbo, Giuseppe; Missale, Gabriele; Marseglia, Mariarosaria; Trevisani, Franco; Foschi, Francesco Giuseppe; Cipriani, Federica; Famularo, Simone; Marra, Fabio; Saitta, Carlo; Serenari, Matteo; Vidili, Gianpaolo; Morisco, Filomena; Caturelli, Eugenio; Mega, Andrea; Pelizzaro, Filippo; Nicolini, Daniele; Ardito, Francesco; Garancini, Mattia; Masotto, Alberto; Baroni, Gianluca Svegliati; Azzaroli, Francesco; Giannini, Edoardo; Perri, Pasquale; Scarinci, Andrea; Fontana, Andrea Pierluigi; Brunetto, Maurizia Rossana; Iaria, Maurizio; Di Marco, Maria; Nardone, Gerardo; Dominioni, Tommaso; Lai, Quirino; Ferrari, Cecilia; Rapaccini, Gian Ludovico; Rodolfo, Sacco; Romano, Maurizio; Conci, Simone; Zoli, Marco; Conticchio, Maria; Zanello, Matteo; Zimmitti, Giuseppe; Fumagalli, Luca; Troci, Albert; Germani, Paola; Gasbarrini, Antonio; La Barba, Giuliano; De Angelis, Michela; Patauner, Stefan; Molfino, Sarah; Zago, Mauro; Pinotti, Enrico; Frigo, Anna Chiara; Baiocchi, Gian Luca; Frena, Antonio; Boccia, Luigi; Ercolani, Giorgio; Tarchi, Paola; Crespi, Michele; Chiarelli, Marco; Abu Hilal, Moh'D; Cescon, Matteo; Memeo, Riccardo; Ruzzenente, Andrea; Zanus, Giacomo; Griseri, Guido; Rossi, Massimo; Maestri, Marcello; Della Valle, Raffaele; Ferrero, Alessandro; Grazi, Gian Luca; Romano, Fabrizio; Giuliante, Felice; Vivarelli, Marco; Jovine, Elio; Torzilli, Guido; Aldrighetti, Luca; De Carlis, Luciano

Titolo:

Liver Resection vs Nonsurgical Treatments for Patients With Early Multinodular Hepatocellular Carcinoma

Anno:

2024

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

JAMA SURGERY

ISSN Rivista:

2168-6254

N° Volume:

159

Numero o Fascicolo:

8

Intervallo pagine:

881-889

Parole chiave:

liver resection, hepatocellular carcinoma, multinodular lesions

Breve descrizione dei contenuti:

Importance The 2022 Barcelona Clinic Liver Cancer algorithm currently discourages liver resection (LR) for patients with multinodular hepatocellular carcinoma (HCC) presenting with 2 or 3 nodules that are each 3 cm or smaller. Objective To compare the efficacy of liver resection (LR), percutaneous radiofrequency ablation (PRFA), and transarterial chemoembolization (TACE) in patients with multinodular HCC. Design, Setting, and Participants This cohort study is a retrospective analysis conducted using data from the HE.RC.O.LE.S register (n = 5331) for LR patients and the ITA.LI.CA database (n = 7056) for PRFA and TACE patients. A matching-adjusted indirect comparison (MAIC) method was applied to balance data and potential confounding factors between the 3 groups. Included were patients from multiple centers from 2008 to 2020; data were analyzed from January to December 2023. Interventions LR, PRFA, or TACE. Main Outcomes and Measures Survival rates at 1, 3, and 5 years were calculated. Cox MAIC-weighted multivariable analysis and competing risk analysis were used to assess outcomes. Results A total of 720 patients with early multinodular HCC were included, 543 males (75.4%), 177 females (24.6%), and 350 individuals older than 70 years (48.6%). There were 296 patients in the LR group, 240 who underwent PRFA, and 184 who underwent TACE. After MAIC, LR exhibited 1-, 3-, and 5-year survival rates of 89.11%, 70.98%, and 56.44%, respectively. PRFA showed rates of 94.01%, 65.20%, and 39.93%, while TACE displayed rates of 90.88%, 48.95%, and 29.24%. Multivariable Cox survival analysis in the weighted population showed a survival benefit over alternative treatments (PRFA vs LR: hazard ratio [HR], 1.41; 95% CI, 1.07-1.86; P = .01; TACE vs LR: HR, 1.86; 95% CI, 1.29-2.68; P = .001). Competing risk analysis confirmed a lower risk of cancer-related death in LR compared with PRFA and TACE. Conclusions and Relevance For patients with early multinodular HCC who are ineligible for transplant, LR should be prioritized as the primary therapeutic option, followed by PRFA and TACE when LR is not feasible. These findings provide valuable insights for clinical decision-making in this patient population.

Id prodotto:

143934

Handle IRIS:

11562/1149765

ultima modifica:

24 gennaio 2025

Citazione bibliografica:

Vitale, Alessandro; Romano, Pierluigi; Cillo, Umberto; Lauterio, Andrea; Sangiovanni, Angelo; Cabibbo, Giuseppe; Missale, Gabriele; Marseglia, Mariarosaria; Trevisani, Franco; Foschi, Francesco Giuseppe; Cipriani, Federica; Famularo, Simone; Marra, Fabio; Saitta, Carlo; Serenari, Matteo; Vidili, Gianpaolo; Morisco, Filomena; Caturelli, Eugenio; Mega, Andrea; Pelizzaro, Filippo; Nicolini, Daniele; Ardito, Francesco; Garancini, Mattia; Masotto, Alberto; Baroni, Gianluca Svegliati; Azzaroli, Francesco; Giannini, Edoardo; Perri, Pasquale; Scarinci, Andrea; Fontana, Andrea Pierluigi; Brunetto, Maurizia Rossana; Iaria, Maurizio; Di Marco, Maria; Nardone, Gerardo; Dominioni, Tommaso; Lai, Quirino; Ferrari, Cecilia; Rapaccini, Gian Ludovico; Rodolfo, Sacco; Romano, Maurizio; Conci, Simone; Zoli, Marco; Conticchio, Maria; Zanello, Matteo; Zimmitti, Giuseppe; Fumagalli, Luca; Troci, Albert; Germani, Paola; Gasbarrini, Antonio; La Barba, Giuliano; De Angelis, Michela; Patauner, Stefan; Molfino, Sarah; Zago, Mauro; Pinotti, Enrico; Frigo, Anna Chiara; Baiocchi, Gian Luca; Frena, Antonio; Boccia, Luigi; Ercolani, Giorgio; Tarchi, Paola; Crespi, Michele; Chiarelli, Marco; Abu Hilal, Moh'D; Cescon, Matteo; Memeo, Riccardo; Ruzzenente, Andrea; Zanus, Giacomo; Griseri, Guido; Rossi, Massimo; Maestri, Marcello; Della Valle, Raffaele; Ferrero, Alessandro; Grazi, Gian Luca; Romano, Fabrizio; Giuliante, Felice; Vivarelli, Marco; Jovine, Elio; Torzilli, Guido; Aldrighetti, Luca; De Carlis, Luciano, Liver Resection vs Nonsurgical Treatments for Patients With Early Multinodular Hepatocellular Carcinoma «JAMA SURGERY» , vol. 159 , n. 8 , 2024 , pp. 881-889

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo