Hepatocellular Carcinoma in Primary Biliary Cholangitis

Sy, Alexander; Ferreira, Raphaella D; John, Binu

doi:10.1016/j.cld.2022.06.011

Cited by 16 publications

(15 citation statements)

References 42 publications

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“…Considerable evidence has demonstrated that PBC increases the risk of HCC. 74 Autoimmune liver illnesses in general also raise the risk of HCC, but at a lesser rate than other liver diseases. 75 The incidence of HCC in PBC, particularly in patients with severe fibrosis, varied widely between 1.9-14%.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

“…75 The incidence of HCC in PBC, particularly in patients with severe fibrosis, varied widely between 1.9-14%. 74 In addition, studies found a combined relative risk of HCC that ranged from 10.8 to 26.8% when compared to that of the general population. 76 Despite the fact that PBC is primarily a female disease, women with PBC cirrhosis had a lower incidence of HCC than men, estrogen may prevent hepatocellular carcinoma by suppressing the cytokines and interleukin-6.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

“…74,76 HCC in PBC is linked to advanced age, male sex, and comorbidities. 74 Additional risk factors for HCC in PBC include concomitant diabetes and obesity (body mass indexes). 77 However, advanced liver fibrosis is the most significant risk factor, 74,76 yet some PBC patients develop HCC without advanced cirrhosis.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

“…77 However, advanced liver fibrosis is the most significant risk factor, 74,76 yet some PBC patients develop HCC without advanced cirrhosis. 74 Till now, the only indication for HCC screening on which all scientific societies agree has been in patients with cirrhosis; nevertheless, hypoalbuminemia, thrombocytopenia, and signs of portal hypertension are all risk factors for the development of HCC. 76 These indicate advanced PBC, thus supporting the HCC screening suggestion for PBC with cirrhosis.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

“…Without treatment, HCC with PBC had a median survival of 36 months, and liver transplantation has the highest survival rate. 74 Currently, the indications for liver transplantation for HCC in PBC are comparable to those for any other form of chronic liver disease with HCC. 80,81 HCC treatment options are also varied with multiple different algorithms published and practiced by different centers; therefore, HCC management should ideally be done through a multidisciplinary approach.…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

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Primary Biliary Cholangitis, Liver Transplantation, and Hepatocellular Carcinoma: A Mini-review

Rawashdeh¹,

Couillard²,

Rawshdeh³

et al. 2022

Gene Expr

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Primary biliary cholangitis (PBC) is an organ-specific chronic autoimmune disease characterized by T-lymphocyte mediated destruction of intrahepatic biliary epithelial cells due to a combination of genetic and possible environmental factors. PBC progresses to hepatic fibrosis and cirrhosis, with the potential of developing hepatocellular carcinoma (HCC) if left untreated. PBC is more common in middle-aged women. It is diagnosed in patients with elevated liver enzymes and the serological hallmark of antimitochondrial antibody (AMA). Early diagnosis and treatment are crucial in improving survival and preventing longterm complications of liver disease. Ursodeoxycholic acid (UDCA) is first-line treatment for PBC. Obeticholic acid (OCA) and fibrates, in combination with UDCA or as monotherapy, may be given to PBC patients with partial or no UDCA response. Liver transplantation has thus been indicated in patients with decompensated cirrhosis or unresectable HCC.

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Section: Hepatocellular Carcinomamentioning

confidence: 99%

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Section: Hepatocellular Carcinomamentioning

confidence: 99%

See 3 more Smart Citations

Primary Biliary Cholangitis, Liver Transplantation, and Hepatocellular Carcinoma: A Mini-review

Rawashdeh¹,

Couillard²,

Rawshdeh³

et al. 2022

Gene Expr

View full text Add to dashboard Cite

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Benign biliary conditions with increased risk of malignant lesions

Welle,

Khot,

Venkatesh

et al. 2024

Abdom Radiol

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Does autoimmune disease impair the survival of hepatocellular carcinoma patients undergoing liver resection? A multi-institutional observational study

Lee,

Chen,

Tsai

et al. 2024

J Cancer Res Clin Oncol

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Background Patients with autoimmune diseases (AD) generally carry an increased risk of developing cancer. However, the effect of AD in hepatocellular carcinoma (HCC) patients receiving surgical treatment is uncertain. The present study aimed to investigate the potential influence of AD on the survival of HCC patients undergoing hepatectomies. Methods Operated HCC patients were identified from the Chang Gung Research Database, and the survival outcomes of HCC patients with or without AD were analyzed ad compared. Cox regression model was performed to identify significant risk factors associated with disease recurrence and mortality. Results From 2002 to 2018, a total of 5532 patients underwent hepatectomy for their HCC. Among them, 229 patients were identified to have AD and 5303 were not. After excluding cases who died within 30 days of surgery, the estimated median overall survival (OS) was 43.8 months in the AD (+) group and 47.4 months in the AD (–) group (P = 0.367). The median liver-specific survival and disease-free survival (DFS) were also comparable between the two groups. After Cox regression multivariate analysis, the presence of AD did not lead to a higher risk of all-cause mortality, liver-specific mortality, or disease recurrence. Conclusion Our study demonstrated that autoimmune disease does not impair the OS and DFS of HCC patients undergoing liver resections. AD itself is not a risk factor for tumor recurrence after surgery. Patients eligible for liver resections, as a result, should be considered for surgery irrespective of the presence of AD. Further studies are mandatory to validate our findings.

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Hepatocellular Carcinoma in Primary Biliary Cholangitis

Cited by 16 publications

References 42 publications

Primary Biliary Cholangitis, Liver Transplantation, and Hepatocellular Carcinoma: A Mini-review

Primary Biliary Cholangitis, Liver Transplantation, and Hepatocellular Carcinoma: A Mini-review

Benign biliary conditions with increased risk of malignant lesions

Does autoimmune disease impair the survival of hepatocellular carcinoma patients undergoing liver resection? A multi-institutional observational study

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