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Abstract Details
Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma
1Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy. Electronic address: egiannini@unige.it.
2Gastroenterology Unit, Department of Internal Medicine, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
3Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Roma-Università Cattolica del Sacro Cuore, Roma, Italy.
4Unit of Infectious Diseases and Hepatology, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.
5Department of Experimental and Clinical Medicine, Internal Medicine and Hepatology Unit, University of Firenze, Firenze, Italy.
6Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padova, Padova, Italy.
7Department of Internal Medicine, Ospedale per gli Infermi di Faenza, Faenza, Italy.
8Gastroenterology Unit, Bolzano Regional Hospital, Bolzano, Italy.
9Gastroenterology Unit, Ospedale Sacro Cuore Don Calabria, Negrar, Italy.
10Department of Clinical and Experimental Medicine, Clinical and Molecular Hepatology Unit, University of Messina, Messina, Italy.
11IRCCS San Raffaele Cassino, Roma, Italy.
12Gastroenterology and Digestive Endoscopy Unit, Foggia University Hospital, Foggia, Italy.
13Gastroenterology Unit, Belcolle Hospital, Viterbo, Italy.
14Department of Clinical Medicine and Surgery, Gastroenterology Unit, University of Napoli ``Federico II'', Napoli, Italy.
15Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
16Department of Medical, Surgical and Experimental Sciences, Clinica Medica Unit, University of Sassari, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy.
17Department of Clinical and Experimental Medicine, Hepatology and Liver Physiopathology Laboratory and Internal Medicine Unit, University of Pisa, Pisa, Italy.
18Department of Clinical Medicine and Surgery, Hepato-Gastroenterology Unit, University of Napoli ``Federico II'', Napoli, Italy.
19Gastroenterology Unit, Polytechnic University of Marche, Ancona, Italy.
20Division of Internal Medicine, Neurovascular and Epatometabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
21Gastroenterology Unit, Department of Surgical and Medical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
22Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Italy.
23Medicine Unit, Bolognini Hospital, Seriate, Italy.
24Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and C.R.C. "A.M. & A. Migliavacca Center for Liver Disease", Milan, Italy.
25Division of Medical Semeiotics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Abstract
Background: Comprehensive and contemporary data pertaining large populations of patients with Primary Biliary Cholangitis (PBC) and hepatocellular carcinoma (HCC) are missing.
Aim: To describe main characteristics and outcome of PBC patients with HCC diagnosed in the new millennium.
Methods: Analysing the Italian Liver Cancer registry we identified 80 PBC patients with HCC diagnosed after the year 2000, and described their clinical characteristics, access to treatment and survival.
Results: Median age of patients was 71 years and 50.0% were males. Cirrhosis was present in 86.3% of patients, being well-compensated in 58.0%. Median HCC diameter was smaller in patients under surveillance (2.6 vs 4.0 cm, P = 0.007). Curative treatment, feasible in 50.0% of patients, was associated with improved survival compared to palliative and supportive care (42 vs 33 vs 6 months, P<0.0001). Surveillance was associated with a non-significant improved survival (36 vs 23 months), likely due to similar rate of curative treatment in patients under (51.4%) and outside surveillance (42.6%).
Conclusions: PBC patients with HCC are often elderly males with well-preserved liver function. Feasibility of curative treatment is high and associated with improved prognosis. Description of these patients may help focus surveillance to identify earlier tumours, increase their curability, and improve prognosis.