title: Hepatocellular carcinoma in thalassaemia: an update of the Italian Registry.
abstract: The risk of developing hepatocellular carcinoma (HCC) in patients with thalassaemia is increased by transfusion-transmitted infections and haemosiderosis. All Italian Thalassaemia Centres use an ad hoc form to report all diagnoses of HCC to the Italian Registry. Since our last report, in 2002, up to December 2012, 62 new cases were identified, 52% of whom were affected by thalassaemia major (TM) and 45% by thalassaemia intermedia (TI). Two had sickle-thalassaemia (ST). The incidence of the tumour is increasing, possibly because of the longer survival of patients and consequent longer exposure to the noxious effects of the hepatotropic viruses and iron. Three patients were hepatitis B surface antigen-positive, 36 patients showed evidence of past infection with hepatitis B virus (HBV). Fifty-four patients had antibodies against hepatitis C virus (HCV), 43 of whom were HCV RNA positive. Only 4 had no evidence of exposure either to HCV or HBV. The mean liver iron concentration was 8 mg/g dry weight. Therapy included chemoembolization, thermoablation with radiofrequency and surgical excision. Three patients underwent liver transplant, 21 received palliative therapy. As of December 2012, 41 patients had died. The average survival time from HCC detection to death was 11·5 months (1·4-107·2 months). Ultrasonography is recommended every 6 months to enable early diagnosis of HCC, which is crucial to decrease mortality.
authors.affiliation: Dipartimento di Scienze Mediche-Pediatria, Università di Ferrara, Ferrara, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Borgna-Pignatti
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Garani
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Forni
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Cappellini
authors.forename: Elena
authors.initials: E
authors.lastname: Cassinerio
authors.forename: Carmelo
authors.initials: C
authors.lastname: Fidone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Spadola
authors.forename: Aurelio
authors.initials: A
authors.lastname: Maggio
authors.forename: Gaetano
authors.initials: G
authors.lastname: Restivo Pantalone
authors.forename: Antonio
authors.initials: A
authors.lastname: Piga
authors.forename: Filomena
authors.initials: F
authors.lastname: Longo
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Gamberini
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricchi
authors.forename: Silvia
authors.initials: S
authors.lastname: Costantini
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Ascola
authors.forename: Paolo
authors.initials: P
authors.lastname: Cianciulli
authors.forename: Maria Eliana
authors.initials: ME
authors.lastname: Lai
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Carta
authors.forename: Angela
authors.initials: A
authors.lastname: Ciancio
authors.forename: Paola
authors.initials: P
authors.lastname: Cavalli
authors.forename: Maria Caterina
authors.initials: MC
authors.lastname: Putti
authors.forename: Susanna
authors.initials: S
authors.lastname: Barella
authors.forename: Giovanni
authors.initials: G
authors.lastname: Amendola
authors.forename: Saveria
authors.initials: S
authors.lastname: Campisi
authors.forename: Marcello
authors.initials: M
authors.lastname: Capra
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Caruso
authors.forename: Grazia
authors.initials: G
authors.lastname: Colletta
authors.forename: Stefano
authors.initials: S
authors.lastname: Volpato
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007501:Iron / Q000378:metabolism; D007558:Italy; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D013789:Thalassemia / Q000097:blood / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D005293:Ferritins; D007501:Iron
keywords: hepatitis C virus; hepatocellular carcinoma; iron overload; liver; thalassaemia