Cancers (Jan 2023)
Role of Etiology in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Counterfactual Event-Based Mediation Analysis
- Rodolfo Sacco,
- Daryl Ramai,
- Raffaella Tortora,
- Giovan Giuseppe di Costanzo,
- Michela Emma Burlone,
- Mario Pirisi,
- Piera Federico,
- Bruno Daniele,
- Marianna Silletta,
- Paolo Gallo,
- Caterina Cocuzza,
- Maurizio Russello,
- Giuseppe Cabibbo,
- Gabriele Rancatore,
- Silvia Cesario,
- Gianluca Masi,
- Luca Marzi,
- Andrea Mega,
- Alessandro Granito,
- Giulia Pieri,
- Edoardo G. Giannini,
- Rosa Paolillo,
- Gennaro Gadaleta-Caldarola,
- Vincenzo Dadduzio,
- Guido Giordano,
- Luca Giacomelli,
- Simonetta Papa,
- Matteo Renzulli,
- Marcello Maida,
- Michele Ghidini,
- Mauro Borzio,
- Antonio Facciorusso
Affiliations
- Rodolfo Sacco
- Gastroenterology and Endoscopy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
- Daryl Ramai
- Gastroenterology and Hepatology, University of Utah, Salt Lake City, UT 84112, USA
- Raffaella Tortora
- Liver Unit, Department of Transplantation, Cardarelli Hospital, 80100 Naples, Italy
- Giovan Giuseppe di Costanzo
- Liver Unit, Department of Transplantation, Cardarelli Hospital, 80100 Naples, Italy
- Michela Emma Burlone
- Department of Internal Medicine, AOU “Maggiore Della Carità”, 28100 Novara, Italy
- Mario Pirisi
- Department of Internal Medicine, AOU “Maggiore Della Carità”, 28100 Novara, Italy
- Piera Federico
- Medical Oncology Unit, Ospedale del Mare, 80100 Naples, Italy
- Bruno Daniele
- Medical Oncology Unit, Ospedale del Mare, 80100 Naples, Italy
- Marianna Silletta
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Paolo Gallo
- Clinical Medicine and Hepatology Unit, Campus Bio-Medico University, 00128 Rome, Italy
- Caterina Cocuzza
- Liver Unit, ARNAS Garibaldi-Nesima, 95100 Catania, Italy
- Maurizio Russello
- Liver Unit, ARNAS Garibaldi-Nesima, 95100 Catania, Italy
- Giuseppe Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90121 Palermo, Italy
- Gabriele Rancatore
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90121 Palermo, Italy
- Silvia Cesario
- Unit of Medical Oncology, AOU Pisana, Santa Chiara Hospital, 56121 Pisa, Italy
- Gianluca Masi
- Unit of Medical Oncology, AOU Pisana, Santa Chiara Hospital, 56121 Pisa, Italy
- Luca Marzi
- Gastroenterology Unit, Bolzano Regional Hospital, 39100 Bolzano, Italy
- Andrea Mega
- Gastroenterology Unit, Bolzano Regional Hospital, 39100 Bolzano, Italy
- Alessandro Granito
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, S. Orsola-Malpighi Hospital, IRCCS AOU di Bologna, 40121 Bologna, Italy
- Giulia Pieri
- Gastroenterology Unit, Department of Internal Medicine, University of Genova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, 16100 Genova, Italy
- Edoardo G. Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, 16100 Genova, Italy
- Rosa Paolillo
- Gastroenterology and Endoscopy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
- Gennaro Gadaleta-Caldarola
- Medical Oncology Unit, Mons. A.R. Dimiccoli Hospital, 76121 Barletta, Italy
- Vincenzo Dadduzio
- Medical Oncology Unit, Mons. A.R. Dimiccoli Hospital, 76121 Barletta, Italy
- Guido Giordano
- Medical Oncology and Biomolecular Therapy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
- Luca Giacomelli
- Polistudium SRL, 20135 Milan, Italy
- Simonetta Papa
- Polistudium SRL, 20135 Milan, Italy
- Matteo Renzulli
- Department of Radiology, IRCCS AOU di Bologna, 40121 Bologna, Italy
- Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
- Michele Ghidini
- Division of Medical Oncology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20100 Milano, Italy
- Mauro Borzio
- Gastroenterologia ed Endoscopia Digestiva, Centro Diagnostico Italiano, 20100 Milan, Italy
- Antonio Facciorusso
- Gastroenterology and Endoscopy Unit, Department of Surgical and Medical Sciences, University of Foggia, 71100 Foggia, Italy
- DOI
- https://doi.org/10.3390/cancers15020381
- Journal volume & issue
-
Vol. 15,
no. 2
p. 381
Abstract
Background: Whether the etiology of underlying liver disease represents a prognostic factor in patients with hepatocellular carcinoma (HCC) treated with lenvatinib is still a matter of debate. This study investigates whether the viral etiology of HCC plays a prognostic role in overall survival (OS). Methods: Data derived from a multicenter series of 313 HCC patients treated with lenvatinib between 2019 and 2022 were analyzed. Actuarial survival estimates were computed using the Kaplan–Meier method and compared with the log-rank test. We performed an event-based counterfactual mediation analysis to estimate direct (chronic inflammation and immunosuppression), indirect (tobacco smoking, alcohol use, illicit drug abuse with injections), and the total effect of viral etiology on OS. Results were expressed as hazard ratio (HR) and 95% CI. Results: Median OS was 21 months (95% CI: 20–23) in the group with other etiologies and 15 months (14–16) in the group with viral etiology (p p < 0.0001). No difference in terms of adverse event rate was observed between the two groups. Conclusions: Patients affected by HCC with nonviral etiology treated with lenvatinib exhibit longer survival than those with viral etiology. This finding may have relevance in the treatment decision-making process.
Keywords
