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Titolo:
Prognostic factors for survival in patients with compensated cirrhosis andsmall hepatocellular carcinoma after percutaneous ethanol injection therapy
Autore:
Pompili, M; Rapaccini, GL; Covino, M; Pignataro, G; Caturelli, E; Siena, DA; Villani, MR; Cedrone, A; Gasbarrini, G;
Indirizzi:
Univ Cattolica Sacro Cuore, Ist Med Interna & Geriatr, I-00168 Rome, ItalyUniv Cattolica Sacro Cuore Rome Italy I-00168 riatr, I-00168 Rome, Italy IRCCS, Div Gastroenterol, San Giovanni Rotondo, Italy IRCCS San Giovanni Rotondo Italy roenterol, San Giovanni Rotondo, Italy
Titolo Testata:
CANCER
fascicolo: 1, volume: 92, anno: 2001,
pagine: 126 - 135
SICI:
0008-543X(20010701)92:1<126:PFFSIP>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACETIC-ACID INJECTION; LIVER-CIRRHOSIS; COMPLICATING CIRRHOSIS; INTERFERON TREATMENT; SURGICAL RESECTION; ALPHA-FETOPROTEIN; ITALIAN PATIENTS; RISK-FACTORS; RECURRENCE; PATTERNS;
Keywords:
hepatocellular carcinoma; cirrhosis; percutaneous ethanol injection; survival analysis; alpha-fetoprotein; tumor recurrence;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
47
Recensione:
Indirizzi per estratti:
Indirizzo: Rapaccini, GL Univ Cattolica Sacro Cuore, Ist Med Interna & Geriatr, LargoA Gemelli 8, I-00168 Rome, Italy Univ Cattolica Sacro Cuore Largo A Gemelli 8 Rome Italy I-00168
Citazione:
M. Pompili et al., "Prognostic factors for survival in patients with compensated cirrhosis andsmall hepatocellular carcinoma after percutaneous ethanol injection therapy", CANCER, 92(1), 2001, pp. 126-135

Abstract

BACKGROUND. The objective of this study was to identify clinical, biochemical, ultrasound, and/or pathologic parameters capable of predicting survival in a cohort of patients with well compensated cirrhosis and small hepatocellular carcinoma (HCC) who were treated with percutaneous ethanol injection (PEI). METHODS. The study group included 111 patients with Child-Pugh Class A cirrhosis and with one (93 patients) or two (18 patients) HCC nodules measuring < 5 cm in greatest dimension. All patients underwent multisession PEI. The prognostic values of pretreatment and post-treatment variables were analyzed using the Kaplan-Meier method. RESULTS. The overall 3-year and 5-year survival rates of 62% and 41%, respectively, were not influenced by age, gender, duration of chronic hepatitis, serum albumin, prothrombin time ratio, total bilirubin, <gamma>-glutamyl transferase, hepatitis B surface antigen, antihepatitis C virus, HCC size, HCC ultrasound pattern, HCC histologic or cytologic grading, greatest spleen dimension, esophageal varices, or ascites. Levels of alpha -fetoprotein (AFP) > 14 ng/mL (P < 0.006), alanine aminotransferase > 75 IU/L (P < 0.04),and aspartate aminotransferase > 80 IU/L (P < 0.009) and platelet count < 92 x 10(9)/L (P < 0.02) before treatment were independent predictors of decreased survival. Among post-treatment parameters, AFP levels 6 months afterPEI > 13.3 ng/mL (P < 0.003) and HCC recurrence in another segment of the liver (P < 0.04) were linked to decreased survival in univariate analysis. CONCLUSIONS. Among patients with Child-Pugh Class A cirrhosis with small uninodular or binodular HCC who are treated with multisession PEI, those with elevated serum AFP and transaminase levels and low platelet count before treatment are characterized by decreased survival. During follow-up, intrahepatic recurrence of the tumor is the main factor affecting survival. Cancer 2001;92:126-35. (C) 2001 American Cancer Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 11:58:50