(23-05-15) Non-alcoholic fatty liver disease becoming major cause of hepatocellular carcinoma

as presented at the annual meeting of the European Association for the Study of the Liver
Non-alcoholic fatty liver disease (NAFLD) is becoming a major cause of hepatocellular carcinoma (HCC) in the U.S., according to a study presented at EASL, held in April in Vienna. The condition is associated with shorter survival time, more advanced tumor stage, and lower possibility of liver transplant. 
Researchers from Inova Fairfax Hospital, Falls Church, Virginia, assessed the incidence and mortality of patients with HCC and NAFLD by examining Surveillance, Epidemiology, and End Results (SEER) registries  for 2004–2009.  They identified 7255 HCC cases and 21,765 controls without HCC. Of the HCC cases, 43% (n=3128) were related to hepatitis C (HCV), 16% (1133) to NAFLD, 13% (975) to alcoholic liver disease (ALD), and 7% (542) to hepatitis B (HBV). Of HCC cases, 16% (1194) did not have a liver disease diagnostic code. Across the six-year period, there was an increasing trend in the number of HCC cases, from 928 (287 per 1000 cases) in 2004 to 1464 (346 per 1000) in 2009, a 4% annual increase. 
The prevalence of HCC in HCV increased by 8% (from 110 per 1000 in 2004 to 156 per 1000 in 2009) with a 5% increase in NAFLD (from 44 per 1000 in 2004 to 55 per 1000 in 2009), all P<0.001. Compared to HBV/HCV patients with HCC, NAFLD with HCC patients were older (74 vs 68 years), more likely to be white, had shorter survival time, higher tumor stage, and more heart disease (all P <0.0001). Also, one-year mortality of HCV/HBV with HCC was about 50%, while it was 70% in NAFLD with HCC (P <0.0001). Of those who received a transplant after HCC diagnosis (n=508); only 4% was related to NAFLD/HCC. In multivariate analysis, NAFLD increased the risk of HCC as compared to the controls without liver disease. Additionally, older age, lower income, un-staged HCC were associated with higher risk of one-year mortality while receiving liver transplant and having localized tumor stage were protective against the risk of one-year mortality (all P <0.05).

SOURCE: quotivadis.it

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