Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study

Maurizio Pompili, Fabio Piscaglia, Gianluca Svegliati-Baroni, Andrea Barchetti, Anna Pecorelli, Sara Marinelli, Claudio Tiribelli, Stefano Bellentani, Mauro Bernardi, Maurizio Biselli, Paolo Caraceni, Marco Domenicali, Francesca Garuti, Annagiulia Gramenzi, Barbara Lenzi, Donatella Magalotti, Matteo Cescon, Matteo Ravaioli, Paolo Del Poggio, Stefano OlmiClaudia Balsamo, Maria Anna Di Nolfo, Elena Vavassori, Alfredo Alberti, Luisa Benvegnàu, Angelo Gatta, Anna Giacomin, Veronica Vanin, Caterina Pozzan, Gemma Maddalo, Emanuela Giampalma, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Paola Roselli, Serena Dell’Isola, Anna Maria Ialungo, Domenico Risso, Simona Marenco, Giorgio Sammito, Linda Bruzzone, Maria Chiaramonte, Maria Guarino, Calogero Cammà, Marcello Maida, Andrea Costantino, Maria Rosa Barcellona, Laura Schiadà, Stefano Gemini, Arianna Lanzi, Giuseppe Francesco Stefanini, Anna Chiara Dall’Aglio, Federica Mirici Cappa, Alessandra Suzzi, Alessandro Mussetto, Omero Treossi, Gabriele Missale, Emanuela Porro, Valeria Mismas, Caterina Vivaldi, Luigi Bolondi, Marco Zoli, Alessandro Granito, Daniela Malagotti, Francesco Tovoli, Franco Trevisani, Laura Venerandi, Giovanni Brandi, Alessandro Cucchetti, Elisabetta Bugianesi, Ester Vanni, Lavinia Mezzabotta, Giuseppe Cabibbo, Salvo Petta, Anna Fracanzani, Silvia Fargion, Fabio Marra, Bernardo Fani, Elisabetta Biasini, Rodolfo Sacco, Filomena Morisco, Nicola Caporaso, Massimo Colombo, Roberta D’Ambrosio, Lory S. Crocè, Riccardo Patti, Edoardo G. Giannini, Paola Loria, Amedeo Lonardo, Enrica Baldelli, Fabio Farinati, Mauro Borzio, Elena Dionigi, Giorgio Soardo, Eugenio Caturelli, Francesca Ciccarese, Roberto Virdone, Andrea Affronti, Francesco Giuseppe Foschi, Franco Borzio

Risultato della ricerca: Contributo in rivistaArticolo in rivista

229 Citazioni (Scopus)

Abstract

Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome and may evolve into hepatocellular carcinoma (HCC). Only scanty clinical information is available on HCC in NAFLD. The aim of this multicenter observational prospective study was to assess the clinical features of patients with NAFLD-related HCC (NAFLD-HCC) and to compare them to those of hepatitis C virus (HCV)-related HCC. A total of 756 patients with either NAFLD (145) or HCV-related chronic liver disease (611) were enrolled in secondary care Italian centers. Survival was modeled according to clinical parameters, lead-time bias, and propensity analysis. Compared to HCV, HCC in NAFLD patients had a larger volume, showed more often an infiltrative pattern, and was detected outside specific surveillance. Cirrhosis was present in only about 50% of NAFLD-HCC patients, in contrast to the near totality of HCV-HCC. Regardless of tumor stage, survival was significantly shorter (P = 0.017) in patients with NAFLD-HCC, 25.5 months (95% confidence interval 21.9-29.1), than in those with HCV-HCC, 33.7 months (95% confidence interval 31.9-35.4). To eliminate possible confounders, a propensity score analysis was performed, which showed no more significant difference between the two groups. Additionally, analysis of patients within Milan criteria submitted to curative treatments did not show any difference in survival between NAFLD-HCC and HCV-HCC (respectively, 38.6 versus 41.0 months, P = nonsignificant) Conclusions: NAFLD-HCC is more often detected at a later tumor stage and could arise also in the absence of cirrhosis, but after patient matching, it has a similar survival rate compared to HCV infection; a future challenge will be to identify patients with NAFLD who require more stringent surveillance in order to offer the most timely and effective treatment. (Hepatology 2016;63:827-838)
Lingua originaleEnglish
pagine (da-a)827-838
Numero di pagine12
RivistaHepatology
Volume63
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular
  • Female
  • Hepatitis C, Chronic
  • Hepatology
  • Humans
  • Liver Neoplasms
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Prospective Studies

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