title: Characteristics of hepatocellular carcinoma in cirrhotic and non-cirrhotic non-alcoholic fatty liver disease.
abstract: OBJECTIVE
  To determine characteristics and prognostic predictors of patients with hepatocellular carcinoma (HCC) in association with non-alcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  We reviewed the records of all patients with NAFLD associated HCC between 2000 and 2012. Data collected included demographics; histology; presence or absence of cirrhosis, size and number of HCC, alpha-fetoprotein, body mass index (BMI), and the presence of diabetes, hypertension, or dyslipidaemia.
  
  
  RESULTS
  Fifty-four patients with NAFLD associated HCC were identified. Mean age was 64 years with 87% male. Fifteen percent (8/54) were not cirrhotic. 11%, 24% and 50% had a BMI of <25 kg/m2, 25-29 kg/m2 and ≥30 kg/m2 respectively. Fifty-nine percent were diabetic, 44% hypertensive and 26% hyperlipidaemic. Thirty-four percent of the patients had ≤1 of these risk factors. Non-cirrhotics had a significantly larger mean tumour diameter at diagnosis than cirrhotics (P=0.041). Multivariate analysis did not identify any other patient characteristics that predicted the size or number of HCC.
  
  
  CONCLUSIONS
  HCC can develop in NAFLD without cirrhosis. At diagnosis such tumours are larger than those in cirrhotics, conferring a poorer prognosis.
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Christopher
authors: C
authors: Leung
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Sern Wei
authors: SW
authors: Yeoh
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Desmond
authors: D
authors: Patrick
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Shara
authors: S
authors: Ket
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Kaye
authors: K
authors: Marion
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Paul
authors: P
authors: Gow
authors: Christopher Leung, Sern Wei Yeoh, Desmond Patrick, Shara Ket, Paul Gow, Peter W Angus, Liver Transplant Unit, Austin Hospital, Heidelberg, Victoria 3084, Australia.
authors: Peter W
authors: PW
authors: Angus
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D047368:Tumor Burden; D014739:Victoria / Q000453:epidemiology
keywords: Cryptogenic cirrhosis; Hepatocellular carcinoma; Metabolic syndrome; Non-alcoholic fatty liver disease; Screening
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