Our new article has been accepted in Liver Cancer:
Schotten C, Bechmann LP, Manka P, Theysohn J, Dechêne A, El Fouly A, Barbato F, Neumann U, Radünz S, Sydor S, Heider D, Venerito M, Canbay A, Gerken G, Herrmann K, Wedemeyer H, Best J: NAFLD-associated comorbidities in advanced stage HCC do not alter the safety and efficacy of Y 90 radioembolization. Liver Cancer 2019, in press.
Background: Patients with advanced hepatocellular carcinoma (HCC) arising in non-alcoholic fatty liver disease (NAFLD) may not be suitable for systemic therapy due to metabolic syndrome-related diseases. Recent trials did not show a survival benefit of radioembolization (RE) compared to sorafenib in advanced stage HCC but may represent an adequate alternative in patients with contraindications to systemic therapy due to its favorable safety profile.
Aim: To investigate the impact of NAFLD related comorbidities on safety and efficacy of RE for HCC treatment in a retrospective monocentric cohort study.
Patients and Methods: Safety and efficacy of RE was evaluated in patients with NAFLD associated HCC. Hepatitis B- virus (HBV) related HCC patients served as controls, exhibiting matching BCLC stages while showing significantly less metabolic comorbidities.
Results: Overall, 87 HCC patients with NAFLD (mean age 71.3 +/- 6.9 years) and 62 HCC patients with HBV (mean age 58.8 +/- 10.9 years) not amenable to surgical or conventional locoregional treatments were included. Patients with HBV related HCC had a comparable liver function to HCC patients with NAFLD. RE treatment related toxicity did not differ between the two groups (increase of bilirubin CTCAE grade in 29 (38.7%) NAFLD and 20 (39.2%) HBV patients, p=0.91). Overall survival was similar in HCC patients with NAFLD and HBV (11.1 (IQR 18.27) vs 9.3 mo. (IQR 14.73) p=0.38), also in the subgroup analyses of BCLC B and C stages.
Conclusion: RE showed similar survival outcomes at a comparable toxicity profile in HCC patients with NAFLD and HBV. NAFLD associated metabolic comorbidities did not exhibit limitations for RE while offering comparable therapeutic efficacy as compared to HBV patients.