Characteristics and Outcomes of Hepatocellular Carcinoma in Patients with Autoimmune Hepatitis.
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Pasta Andrea, Pieri Giulia, Plaz Torres Maria Corina, Missale Gabriele, Foschi Francesco Giuseppe, Piscaglia Fabio, Boninsegna Sara, Mega Andrea, Cazzagon Nora, Pelizzaro Filippo, Viganò Mauro, Trevisani Franco, Bucci Laura, Azzaroli Francesco, Brunetto Maurizia Rossana, Campani Claudia, Celsa Ciro, Ghittoni Giorgia, Magalotti Donatella, Martini Andrea, Morisco Filomena, Nardone Gerardo, Ponziani Francesca Romana, Sacco Rodolfo, Sacerdoti David, Saitta Carlo, Sangiovanni Angelo, Lani Lorenzo, Svegliati-Baroni Gianluca, Vidili Gianpaolo, Vitale Alessandro, Giannini Edoardo G, Italian Liver Cancer (ITA.LI.CA) Group
Аннотация
AIM: To describe the main characteristics and outcome of patients with AIH and HCC.
METHODS: Among patients with HCC included in the Italian Liver Cancer (ITA.LI.CA) database during the period 2009-2022, we selected those with AIH, and we described their liver disease characteristics, modality of HCC diagnosis, tumor stage, treatment, and outcome.
RESULTS: Among 10,026 patients with HCC, we identified 23 patients (0.2%) with AIH (43.5% males, 69.6% aged > 65 years, 91.0% with cirrhosis). Fifteen patients (65.2%) had co-factors of liver disease [8 patients (34.8%) metabolic dysfunction-associated steatotic liver disease, 4 patients (17.4%) alcohol abuse, 3 patients (13.0%) AIH/Primary Biliary Cholangitis overlap syndrome]. Tumors diagnosed under surveillance (60.9%) were more frequently uninodular (85.7% vs 66.6%, p = 0.146) and Milan-in (85.7% vs 44.4%, p = 0.066) than those diagnosed outside surveillance. Treatment with curative intent was more frequent among patients under surveillance (78.6% vs 33.3%, p = 0.077). Median overall survival was 41.7 months and was remarkably longer in patients under surveillance than in those diagnosed outside surveillance (68.2 vs 27.4 months, p = 0.032).
CONCLUSION: AIH accounts for a minimal fraction of patients with HCC, and in most patients, risk co-factors for HCC are present. In patients with AIH, too, surveillance is associated with better tumor stage, higher access rate to potentially curative treatments, and improved survival.