Digestive System Diseases

Symptoms and General Pathology

All Conditions

Neoplasms

Liver Cirrhosis

Carcinoma

Carcinoma, Hepatocellular

Fibrosis

Hematinics

All Drugs and Chemicals

Liver Extracts

Description of the cirrhosis management

Olivier GANRY, MD, PhD

Hepatocellular carcinoma (HCC) has become the second most common cause of cancer death in the world, estimated responsible for nearly 745,000 deaths in 2012 (9.1% of all cancer deaths).

Hepatocellular carcinoma (HCC) has become the second most common cause of cancer death in the world, estimated responsible for nearly 745,000 deaths in 2012 (9.1% of all cancer deaths). This cancer is closely associated with the presence of chronic liver underlying disease and early diagnosis following a systematic surveillance of cirrhotic patients could improve disease-free survival in patients declaring HCC. However, the risk-benefit ratio of such monitoring is discussed. Nevertheless, it is recommended in patients with liver cirrhosis, from which the prevalence is estimated between 0.3% and 0.6% in the French population. This debate can lead to a failure to comply with recommendations and promote a large variability in the management of the surveillance of HCC in patients with cirrhosis in practice. Data acquisition regarding the current situation in France is required.

The objective of this project is to use this database to document current practices concerning monitoring of incidents HCC in cirrhotic patients in France. A retrospective cohort study will be conducted on data from SNIIRAM recorded between 2007 and 2015. The primary analysis will focus on multivariate modelling of the deviation rate from the recommendations (advising the realisation of at least two echodoppler ultrasonographies yearly) with a competitive risk model, taking into account gender, social status, Charlson index, age at baseline, the alcoholic etiology of cirrhosis, type of facility and the yearly number of visits to a hepatologist during follow-up. It is estimated that more than 86,000 patients with a minimum follow-up of 3 years will be included in the analysis

Use of the French Healthcare Insurance Database

Use of the French Healthcare Insurance Database to Evaluate How Early Diagnosis of Hepatocellular Carcinomas is Implemented in France: SAMHEPAT Study

A multivariate regression analysis will be performed to objectivate factors associated with the deviation among sex, poor social status, Charlson index, age at inclusion and the alcoholic aetiology of the cirrhosis, type facility where hospitalisation occurred, number of hepatologist visits and living area

Centre Hospitalier Universitaire, Amiens

Liver Diseases

Liver Neoplasms

Hepatic Insufficiency

Liver Failure

Gastrointestinal Diseases

Gastrointestinal Neoplasms

Digestive System Neoplasms

Antineoplastic Agents

Anti-Infective Agents

Everolimus

Tacrolimus

Sirolimus

Temsirolimus

MTOR Inhibitors

Protein Kinase Inhibitors

Enzyme Inhibitors

Immunosuppressive Agents

Immunologic Factors

Standard immunosuppression protocol with Tacrolimus, maintaining trough levels between 6 and 12 ng/ml in the first month, in association with steroids (20 mg/day with subsequent weaning within 3 months after transplantation).

Administration of Everolimus in association with Tacrolimus and steroids.

Administration of Everolimus within 24 hours from the time of randomization (7 days from the time of transplantation) in association with Tacrolimus and steroids. The first dose level of the trough will be performed at day 7 after initiation of therapy. After the reaching an Everolimus trough level of \>5ng/ml (final target 6-12 ng/ml), there will be a gradual weaning of tacrolimus (bringing Tacrolimus blood levels \<5 ng/ml) with discontinuation of Tacrolimus within 30 days after transplantation when possible.

Umberto Cillo, MD

Laura Saracino, MSc

Michele Colledan, MD

Vittorio Corno, MD

Giorgio Rossi, MD

Paolo Reggiani, MD

Luciano De Carlis, MD

Jacopo Mangoni, MD

Laura Saracino, MBS

Giacomo Zanus, MD

Daniele Neri, MD

Patrizia Boccagni, MD

Francesco D'Amico, MD

Enrico Gringeri, MD

Alessandro Vitale, MD

Pasquale Bonsignore, MD

Paolo Feltracco, MD

Dino Sgarabotto, MD

Roberto Marchini, MD

Angelica Magrofuoco, CCTC

Salvatore Agnes, MD

Erida Nure, MD

Mauro Salizzoni, MD

Francesco Lupo, MD

Fabio Bresàdola, MD

Umberto Baccarani, MD

Safety and Efficacy of Everolimus in adult de novo liver transplant recipients.

This prospective study was designed to evaluate the feasibility and effectiveness of the use of Everolimus in the minimization and possible suspension of calcineurin inhibitors in adult liver transplant patients. The study will take into account a control group (standard immunosuppression with tacrolimus and steroids) after induction with anti-IL2 Antibodies.

Everolimus in de Novo Liver Transplantation: a Multicentre Randomized Study

Terapia Con Everolimus Nel Trapianto de Novo di Fegato: Uno Studio Multicentrico Randomizzato

Patients not requiring calcineurin inhibitors (CNI)

Impact of therapy on renal function, evaluated by creatinine clearance according to the Modification of Diet in Renal Disease (MDRD) Study.

Evaluation of common post Liver Transplantation Adverse Events:

wound healing, bone marrow depression, hyperlipidemia, proteinuria, diabetes mellitus, diagnosed hypertension, infections, levels of HCV.

Azienda Ospedaliera di Padova

Director of the Hepatobiliary Surgery and Liver Transplantation Unit

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Use of the French Healthcare Insurance Database	NCT02983968	Cirrhosis	Description of ...	18 Years - 75 Years	Centre Hospitalier Universitaire, Amiens
Everolimus in de Novo Liver Transplantation: a Multicentre Randomized Study	NCT01423708	Liver Failure Liver Diseases Liver Cirrhosis Liver Neoplasms	Everolimus	18 Years - 70 Years	Azienda Ospedaliera di Padova
Everolimus in de Novo Liver Transplantation: a Multicentre Randomized Study	NCT01423708	Liver Failure Liver Diseases Liver Cirrhosis Liver Neoplasms	Everolimus	18 Years - 70 Years	Azienda Ospedaliera di Padova
Everolimus in de Novo Liver Transplantation: a Multicentre Randomized Study	NCT01423708	Liver Failure Liver Diseases Liver Cirrhosis Liver Neoplasms	Everolimus	18 Years - 70 Years	Azienda Ospedaliera di Padova

Spots Global Cancer Trial Database for hepatology

Every month we try and update this database with for hepatology cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for hepatology

Every month we try and update this database with for hepatology cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for hepatology cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.