{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:02:38Z","timestamp":1761663758554,"version":"3.37.3"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"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":["Liver International"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Metabolic disorders are well\u2010known risk factors for HCC<\/jats:styled-content>. Conversely, their impact on the natural history of HCC<\/jats:styled-content> is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC<\/jats:styled-content> patients regardless of its aetiology.<\/jats:p><\/jats:sec>Methods<\/jats:title>We analysed the ITA<\/jats:styled-content>.LI<\/jats:styled-content>.CA<\/jats:styled-content> database regarding 839 HCC<\/jats:styled-content> patients prospectively collected. The following metabolic features were analysed: BMI<\/jats:styled-content>, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0\u20101, 2 and 3\u20105 metabolic features.<\/jats:p><\/jats:sec>Results<\/jats:title>As compared with patients with 0\u20101 metabolic features, patients with 3\u20105 features showed lower percentage of HCC<\/jats:styled-content> diagnosis on surveillance (P<\/jats:italic>\u00a0=\u00a0.021), larger tumours (P<\/jats:italic>\u00a0=\u00a0.038), better liver function (higher percentage of Child\u2010Pugh class A [P<\/jats:italic>\u00a0=\u00a0.007] and MELD<\/jats:styled-content>\u00a0<\u00a010 [P<\/jats:italic>\u00a0=\u00a0.003]), higher percentage of metastasis (P<\/jats:italic>\u00a0=\u00a0.024) and lower percentage of portal vein thrombosis (P<\/jats:italic>\u00a0=\u00a0.010). The BCLC<\/jats:styled-content> stage and treatment options were similar among the 3 groups, with the exception of a less frequent access to loco\u2010regional therapies for BCLC<\/jats:styled-content> stage B patients with 3\u20105 features (P<\/jats:italic>\u00a0=\u00a0.012). Overall survival and survival according to BCLC<\/jats:styled-content> stage and\/or treatment did not significantly differ among the 3 groups. Only using a probabilistic sensitivity analysis, diabetic patients showed a lower survival (P<\/jats:italic>\u00a0=\u00a0.046). MELD<\/jats:styled-content> score, HCC<\/jats:styled-content> morphology, nodule size, BCLC<\/jats:styled-content> stage, portal vein thrombosis and metastasis were independent predictors of lead\u2010time adjusted survival.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our \u201creal world\u201d study suggests that metabolic disorders shape the clinical presentation of HCC<\/jats:styled-content> but do not seem to play a major role in setting patient survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13877","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T12:19:34Z","timestamp":1525954774000},"page":"2028-2039","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Metabolic disorders across hepatocellular carcinoma in Italy"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9059-8311","authenticated-orcid":false,"given":"Filomena","family":"Morisco","sequence":"first","affiliation":[{"name":"Gastroenterology Unit Department of Clinical Medicine and Surgery Federico II University Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-4122","authenticated-orcid":false,"given":"Maria","family":"Guarino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Clinical Medicine and Surgery Federico II University Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria R.","family":"Valvano","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Casa Sollievo Sofferenza Hospital, IRCCS San Giovanni Rotondo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Auriemma","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Clinical Medicine and Surgery Federico II University Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Farinati","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology Department of Surgery, Oncology and Gastroenterology Padua University Hospital Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo G.","family":"Giannini","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department Internal Medicine Policlinico San Martino, University of Genoa Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Ciccarese","sequence":"additional","affiliation":[{"name":"Surgery Unit Policlinico San Marco Zingonia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-1155","authenticated-orcid":false,"given":"Francesco","family":"Tovoli","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit Department of Medical and Surgical Sciences Alma Mater Studiorum\u2010University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Ludovico","family":"Rapaccini","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Gastroenterology Complesso Integrato Columbus Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Division of Medicine Bolognini Hospital Seriate Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenio","family":"Caturelli","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Belcolle Hospital Viterbo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Zoli","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit Department of Medical and Surgical Sciences Alma Mater Studiorum\u2010University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Borzio","sequence":"additional","affiliation":[{"name":"Division of Radiology Department of Medicine Fatebenefratelli Hospital Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Sacco","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Metabolic Diseases University Hospital of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0946-3859","authenticated-orcid":false,"given":"Giuseppe","family":"Cabibbo","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.) University of Palermo Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Felder","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Bolzano Regional Hospital Bolzano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luisa","family":"Benveng\u00f9","sequence":"additional","affiliation":[{"name":"Medical Unit Department of Clinical and Experimental Medicine University of Padua Paadua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Gasbarrini","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario A. Gemelli, Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4399-3359","authenticated-orcid":false,"given":"Gianluca","family":"Svegliati Baroni","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Polytechnic University of Marche Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco G.","family":"Foschi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Ospedale per gli Infermi di Faenza Faenza Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Biasini","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hepatology Parma University Hospital Parma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Masotto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Ospedale Sacro Cuore Don Calabria Negrar Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Virdone","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine 2 Ospedali Riuniti Villa Sofia Cervello Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-0878","authenticated-orcid":false,"given":"Fabio","family":"Marra","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine Internal Medicine and Hepatology University of Firenze Firenze Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Caporaso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Clinical Medicine and Surgery Federico II University Naples Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6393-6995","authenticated-orcid":false,"given":"Franco","family":"Trevisani","sequence":"additional","affiliation":[{"name":"Semeiotica Medica Unit Department of Medical and Surgical Sciences Alma Mater Studiorum \u2010 University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the Italian Liver Cancer (ITA.LI.CA) group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"International Agency for Research on Cancer.GLOBOCAN 2012: Estimated Cancer Incidence Mortality and Prevalence Worldwide in 2012. Liver.globocan.iarc.fr\/Pages\/fact_sheets_cancer.aspx.Accessed January 10 2014; Elsevier Limited 2014."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1001683"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.10.027"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.12.012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.05.026"},{"key":"e_1_2_8_7_1","first-page":"875","article-title":"Changing aetiological factors of hepatocellular carcinoma and their potential impact on the effectiveness of surveillance","volume":"43","author":"Stroffolini T","year":"2011","journal-title":"Dig Liver Dis"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.09.013"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11523-016-0454-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27172"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27014"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13191"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2174\/15733998113099990068"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200503313521322"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v5.i9.186"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24397"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01858.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24687"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22734"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3182a030c4"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-014-0973-8"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28706"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.12.001"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24199"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007122"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247133"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2013.01.012"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02409.x"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01719.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-016-1498-3"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-016-0508-7"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2014.01.011"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28368"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i14.4103"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443743"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13204"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4229-z"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1499-3872(11)60059-3"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i43.9571"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010301)91:5<957::AID-CNCR1085>3.0.CO;2-J"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13670"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12888"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20160438"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.14640"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1159\/000477578"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fliv.13877","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.13877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T11:50:07Z","timestamp":1694865007000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.13877"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,19]]},"references-count":44,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/liv.13877"],"URL":"https:\/\/doi.org\/10.1111\/liv.13877","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"type":"print","value":"1478-3223"},{"type":"electronic","value":"1478-3231"}],"subject":[],"published":{"date-parts":[[2018,6,19]]},"assertion":[{"value":"2017-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}