Gross Pathologic Types of Hepatocellular Carcinoma in ItalyStroffolini T. · Andreone P. · Andriulli A. · Ascione A. · Craxì A. · Chiaramonte M. · Galante D. · Manghisi O.G. · Mazzanti R. · Medaglia C. · Pilleri G. · Rapaccini G.L. · Albanese M. · Taliani G. · Tosti M.E. · Villa E. · Gasbarrini G.
aLaboratorio di Epidemiologia, ISS, Roma, bIstituto di Patologia Medica, University of Bologna, cDepartment of Gastroenterology, IRCCS. S. Giov. Rotondo Hospital, Sangiovanni Rotondo, dDepartment of Gastroenterology, Cardarelli Hospital Napoli, eIstituto di Medicina Interna, University of Palermo, fDivisione Gastroenterologia, University of Padova, gClinica Malattie Infettive, University of Napoli, hDepartment of Gastroenterology, Castellana Grotte Hospital, Castellana Grotte, iIstituto di Clinica Medica, University of Firenze, jIstituto di Medicina Interna, IRCCS Maggiore Hospital, Milano, kDepartment of Internal Medicine, Cagliari Hospital, Cagliari, lClinica Medica, Policlinico Gemelli, University of Rome, mClinica Medica R, University of Palermo, nClinica Malattie Tropicali, University of Rome, and oDivisione Gastroenterologia, University of Modena, Italy
The prevalence and independent predictors of the different macroscopic types of hepatocellular carcinoma (HCC) were assessed in 1,073 unselected patients of 14 hospitals in Italy from May 1996 to May 1997. Solitary HCC was the most common cancer type (44.6%), followed by multinodular (44.2%), diffuse (8.4%) and massive (2.8%) types. After adjustment for the influence of confounders by multiple logistic regression analysis, Child-Pugh grades B and C were found to be independent predictors of multinodular (odds ratio, OR, 2.0; 95% confidence interval (CI) = 1.5–2.6) and diffuse (OR 2.6; 95% CI = 1.6–4.4) HCC types. These findings indicate that the majority of HCC cases are not detected at a potentially treatable stage. Delayed detection of HCC is associated with a higher likelihood of the multinodular or diffuse gross pathologic type.