{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:00:53Z","timestamp":1761663653218},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The Barcelona Clinic Liver Cancer (BCLC) algorithm is the standard system for clinical management of hepatocellular carcinoma (HCC). Data on adherence to this therapeutic paradigm are scarce. This field practice study aimed to provide a description of HCC cirrhotic patients in Southern Italy, to evaluate the adherence to BCLC guidelines and its impact on patients' survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed the region\u2010wide Italian database of <jats:italic>Progetto Epatocarcinoma Campania<\/jats:italic>, which includes data of HCC cirrhotic patients, prospectively collected from January 2013 to December 2015 in 16 regional centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1008 HCC patients were enrolled: 70.6% patients received therapies recommended by BCLC algorithm, while 29.4% underwent different treatments. Among patients who were treated in adherence to guidelines, a higher rate of diagnosis on surveillance programs, better liver function, lower rate of alpha\u2010fetoprotein &gt;\u00a0200\u00a0ng\/mL, more early\u2010stage and monofocal HCC, lower frequency of nodules &gt;\u00a05\u00a0cm, portal vein thrombosis and metastases were observed. The overall survival was evaluated according to HCC stage and no differences between groups and patients managed differently were found. The multivariate analysis showed that non\u2010adherence to treatment guidelines was independently associated to the BCLC stage B, Child\u2013Pugh classes B and C, and the presence of neoplastic thrombosis and metastases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adherence to BCLC algorithm in field practice was high in early and end\u2010stage HCC patients, but it was poor in intermediate and advanced patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14013","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T01:12:36Z","timestamp":1507597956000},"page":"1123-1130","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Adherence to Barcelona Clinic Liver Cancer guidelines in field practice: Results of Progetto Epatocarcinoma Campania"],"prefix":"10.1111","volume":"33","author":[{"given":"Maria","family":"Guarino","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Department of Clinical Medicine and Surgery University of Naples \u201cFederico II\u201d  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaella","family":"Tortora","sequence":"additional","affiliation":[{"name":"Hepatology Unit \u201cCardarelli\u201d Hospital  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"de Stefano","sequence":"additional","affiliation":[{"name":"IX Interventional Ultrasound Unit for Infectious Diseases AORN dei Colli, P.O. 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Sebastiano Hospital  Caserta Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampiero","family":"Francica","sequence":"additional","affiliation":[{"name":"Interventional Ultrasound Unit, Department of Radiology Pineta Grande Hospital  Castel Volturno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"De Girolamo","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit PSI Napoli EST \u2010 ASL NA 1  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Coppola","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Public Medicine, Section of Infectious Diseases University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello","family":"Persico","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Salerno  Salerno Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovan Giuseppe","family":"Di Costanzo","sequence":"additional","affiliation":[{"name":"Hepatology Unit \u201cCardarelli\u201d Hospital  Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Progetto Epatocarcinoma Campania Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,7]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"I numeri del cancro in Italia 2014. 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