Surveillance for Hepatocellular Carcinoma Also Improves Survival of Incidentally Detected Intrahepatic Cholangiocarcinoma Arisen in Liver Cirrhosis
| العنوان: | Surveillance for Hepatocellular Carcinoma Also Improves Survival of Incidentally Detected Intrahepatic Cholangiocarcinoma Arisen in Liver Cirrhosis |
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| المؤلفون: | Letizia Veronese, Fabio Piscaglia, Federico Stefanini, Giovanni Brandi, Stefania De Lorenzo, Massimo Iavarone, Francesca Benevento, Francesco Tovoli, Pietro Guerra, Matteo Renzulli |
| المساهمون: | Tovoli F., Guerra P., Iavarone M., Veronese L., Renzulli M., De Lorenzo S., Benevento F., Brandi G., Stefanini F., Piscaglia F. |
| المصدر: | Liver Cancer Liver Cancer, Vol 9, Iss 6, Pp 744-755 (2020) |
| بيانات النشر: | S. Karger AG, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cirrhosis, liver cirrhosis, Population, cholangiocellular carcinoma, outcomes, lcsh:RC254-282, Gastroenterology, Liver cirrhosi, 03 medical and health sciences, 0302 clinical medicine, intrahepatic cholangiocarcinoma, Internal medicine, Overall survival, Medicine, education, Intrahepatic Cholangiocarcinoma, Outcome, Original Paper, education.field_of_study, Hepatology, business.industry, screening, Aggressive cancer, Retrospective cohort study, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Propensity score matching, 030211 gastroenterology & hepatology, business |
| الوصف: | Background: Due to its poor survival, intrahepatic cholangiocarcinoma (ICC) is held to be a much more aggressive cancer than hepatocellular carcinoma (HCC). In most published series, patients were diagnosed when symptomatic. However, ICC is now increasingly being discovered during the surveillance for HCC in cirrhosis. Whether this earlier detection of ICC is associated with an equally dismal prognosis or not is unknown. Methods: This is amulticenter retrospective study of consecutive ICC patients. Patients were stratified into subgroups according to the absence/presence of cirrhosis. A propensity score matching was performed to reduce the potential biases. Cirrhotic patients were further stratified according to their surveillance status. The lead-time bias and its potential effects were also estimated. Results: We gathered 184 patients. Eighty-five patients (46.2%) were cirrhotic. Liver cirrhosis was not related to a worse overall survival (33.0 vs. 32.0 months, p = 0.800) even after the propensity score analysis (43.0 in vs. 44.0 months in 54 pairs of patients, p = 0.878). Among the cirrhotic population, 47 (55.3%) patients had received a diagnosis of ICC during a surveillance programme. The 2 subgroups differed in maximum tumour dimensions (30 vs. 48 mm in surveyed and non-surveyed patients, respectively). Surveyed patients were more likely to receive surgical treatments (59.8 vs. 28.9%, p = 0.003). Overall survival was higher in surveyed patients (51.0 vs. 21.0 months, p < 0.001). These benefits were confirmed after correcting for the lead-time bias. Conclusions: Cirrhotic patients have different clinical presentation and outcomes of ICC according to their surveillance status. In our series, ICC in cirrhosis was not associated with worse OS. Cirrhosis itself should not discourage either surgical or non-surgical treatments. |
| وصف الملف: | ELETTRONICO |
| تدمد: | 1664-5553 2235-1795 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f12e3873fd3db5b7ffb989143c776769Test https://doi.org/10.1159/000509059Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f12e3873fd3db5b7ffb989143c776769 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16645553 22351795 |
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