Additional members of the ITA.LI.CA groups are listed in the .
Rise and fall of HCV-related hepatocellular carcinoma in Italy: a long-term survey from the ITA.LI.CA centres
Article first published online: 12 JUN 2013
© 2013 John Wiley & Sons A/S
Volume 33, Issue 9, pages 1420–1427, October 2013
How to Cite
Liver Int. 2013; 33:1420–1427
- Issue published online: 8 SEP 2013
- Article first published online: 12 JUN 2013
- Accepted manuscript online: 9 MAY 2013 01:53AM EST
- Manuscript Accepted: 1 MAY 2013
- Manuscript Received: 22 AUG 2012
- hepatitis C;
- hepatocellular carcinoma;
Background & Aims
Hepatitis C virus (HCV) is the leading aetiological factor of HCC in the western world where, overall, its incidence is increasing, despite data suggesting an initial drop in some areas. The aim of this study was to evaluate epidemiology, clinical features and survival of HCV-related HCC (HCV-HCC) in a wide time range in Italy.
Multicentre retrospective study including 3695 patients prospectively recruited by the ITA.LI.CA group. Patients were classified into three subgroups according to aetiology (Group A[GA], pure HCV; Group B[GB], HCV + cofactors; and Group C[GC], non-HCV) and in 5 time cohorts (5 years each), according to the year of diagnosis. Age, gender, Child–Pugh score, modality of diagnosis, stage, presence of thrombosis/metastases, type of treatment and survival were analysed.
A total of 1801 GA patients, 445 GB and 1333 GC were recruited. The number of GA patients peaked in the 1996–2000, gradually dropping thereafter (P < 0.0001), as observed for GB (P < 0.0001). Age at diagnosis increased (P < 0.0001), while percentage of patients diagnosed during surveillance and stage improved only in GA (P = 0.02 and P = 0.003 respectively). The survival significantly increased over time particularly in GA (median 37 months) and was longer in GA than in GB and GC (P < 0.0001).
The prevalence of HCC-HCV is decreasing in Italy since 2001. HCV-HCC patients are older, more frequently diagnosed under surveillance and in an earlier stage. HCC survival improved in the last 15 years and is significantly higher in patients with HCV-HCC. We therefore expect a further drop in both incidence and mortality for HCV-HCC in the years to come.