Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study
Articolo
Data di Pubblicazione:
2016
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 5 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 5 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.
Tipologia CRIS:
03A-Articolo su Rivista
Elenco autori:
Piscaglia, F; Svegliati Baroni, G; Barchetti, A; Pecorelli, A; Marinelli, S; Tiribelli, C; Bellentani, S; Bernardi, M; Biselli, M; Caraceni, P; Domenicali, M; Garuti, F; Gramenzi, A; Lenzi, B; Magalotti, D; Cescon, M; Ravaioli, M; Del Poggio, P; Olmi, S; Rapaccini, Gl; Balsamo, C; Di Nolfo, Ma; Vavassori, E; Alberti, A; Benvegnù, L; Gatta, A; Giacomin, A; Vanin, V; Pozzan, C; Maddalo, G; Giampalma, E; Cappelli, A; Golfieri, R; Mosconi, C; Renzulli, M; Roselli, P; Dell'Isola, S; Ialungo, Am; Risso, D; Marenco, S; Sammito, G; Bruzzone, L; Bosco, G; Grieco, A; Pompili, M; Rinninella, E; Siciliano, M; Chiaramonte, M; Guarino, M; Cammà, C; Maida, M; Costantino, A; Barcellona, Mr; Schiadà, L; Gemini, S; Lanzi, A; Stefanini, Gf; Dall'Aglio, Ac; Cappa, Fm; Suzzi, A; Mussetto, A; Treossi, O; Missale, G; Porro, E; Mismas, V; Vivaldi, C; Bolondi, L; Zoli, M; Granito, A; Malagotti, D; Tovoli, F; Trevisani, F; Venerandi, L; Brandi, G; Cucchetti, A; Bugianesi, Elisabetta; Vanni, Ester; Mezzabotta, Lavinia; Cabibbo, G; Petta, S; Fracanzani, A; Fargion, S; Marra, F; Fani, B; Biasini, E; Sacco, R; Morisco, F; Caporaso, N; Guarino, M; Colombo, M; D'Ambrosio, R; Crocè, Ls; Patti, R; Giannini, Eg; Loria, P; Lonardo, A; Baldelli, E; Miele, L; Grieco, A; Farinati, F; Pozzan, C; Borzio, M; Dionigi, E; Soardo, G; Caturelli, E; Roselli, P; Ciccarese, F; Virdone, R; Affronti, A; Foschi, Fg; Borzio, F.
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