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

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          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)

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          Author and article information

          Journal
          Hepatology
          Hepatology (Baltimore, Md.)
          1527-3350
          0270-9139
          Mar 2016
          : 63
          : 3
          Affiliations
          [1 ] Unità di Medicina, Dipartimento di Scienze Mediche e Chirurgiche, Policlinico S. Orsola-Malpighi, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
          [2 ] Department of Gastroenterology and Obesity Center, Università Politecnica delle Marche, Ancona, Italy.
          [3 ] Centro Studi Fegato, Fondazione Italiana Fegato-Science Park-Basovizza Campus, Trieste, Italy.
          [4 ] Dipartimento di Scienze Mediche, Università di Trieste, Trieste, Italy.
          Article
          10.1002/hep.28368
          26599351
          044438f0-e755-411e-921f-2e21a5c868f7
          © 2015 by the American Association for the Study of Liver Diseases.
          History

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