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. 2022 Sep 7:77:100097.
doi: 10.1016/j.clinsp.2022.100097. eCollection 2022.

Hepatocellular carcinoma (HCC) in patients with Non-Alcoholic Fatty Liver Disease (NAFLD): screening, treatment and survival analysis in a Brazilian series

Regiane Saraiva de Souza Melo Alencar  1 , Claudia P Oliveira  2 , Aline Lopes Chagas  1 , Leonardo Gomes da Fonseca  1 , Claudia Maccali  1 , Lisa Rodrigues da Cunha Saud  1 , Mariana Pinheiro Xerfan  1 , Jose Tadeu Stefano  2 , Paulo Herman  3 , Luiz Augusto Carneiro D'Albuquerque  4 , Venâncio Avancini Ferreira Alves  5 , Flair Jose Carrilho  6
Affiliations

Hepatocellular carcinoma (HCC) in patients with Non-Alcoholic Fatty Liver Disease (NAFLD): screening, treatment and survival analysis in a Brazilian series

Regiane Saraiva de Souza Melo Alencar et al. Clinics (Sao Paulo). .

Abstract

Objective: The aim of the present study was to evaluate the clinical features, Hepatocellular Carcinoma (HCC) screening, treatment modalities, and Overall Survival (OS) in a series of Non-Alcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma (NAFLD-HCC) Brazilian patients.

Methods: This was a cross-sectional study at the Instituto do Cancer do Estado de São Paulo, at the Faculdade de Medicina da Universidade de São Paulo with the approval of the local research ethics committee. NAFLD patients with HCC diagnosed, from May 2010 to May 2019, were included.

Results: A total of 131 patients were included. Risk factors for NAFLD were present in 94.7% of the patients. Only 29% of patients were in the HCC screening program before diagnosis. HCC treatment was performed in 84.7% of patients. Cumulative survival at the end of the first year was 72%, second-year 52%, and fifth-year 32%. HCC screening before diagnosis was not significantly associated with higher cumulative survival. The independent factors associated with shorter general survival were BCLC C-D, p < 0.001, and the size of the largest nodule > 42 mm, p = 0.039.

Conclusions: Although the efficacy of screening in our population regarding overall survival was hampered due to the sample size (29% had screening), BCLC stages C‒D and the size of the largest nodule larger than 42 mm were identified as independent factors of worse prognosis.

Keywords: HCC screening program; Hepatocellular carcinoma; Non-alcoholic fatty liver disease; Overall survival; Treatment.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Overall survival function in the set of evaluated individuals.
Figure 2
Figure 2
Overall survival function including crude effect (a) and adjusted effect (b) of HCC screening.
Figure 3
Figure 3
Overall survival function including the adjusted effect of Barcelona Clinic Liver Cancer Group stage at diagnosis.
Figure 4
Figure 4
Overall survival function including adjusted effect of size of the largest nodule.
Figure 5
Figure 5
Overall survival function including crude effect (a) and adjusted effect (b) of HCC treatment.
Figure 6
Figure 6
Overall survival function including adjusted effect of Barcelona Clinic Liver Cancer Group stage in the HCC treatment.
Figure 7
Figure 7
Overall survival function including adjusted effect of size of the largest nodule in the HCC treatment.
See this image and copyright information in PMC

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