2021 Webinar: NASH as a Cause of Hepatocellular Carcinoma-NASH as a Cause of Hepatocellular Carcinoma

Video Transcription

Video Summary

In a recent AASLD webinar, experts discussed the epidemiology, prevention, and management of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). The webinar highlighted the importance of surveillance for early detection of HCC, with ultrasound and alpha-fetoprotein level testing recommended every six months for patients with cirrhosis. However, adherence to surveillance is generally poor, and efforts should be made to address barriers to adherence, particularly in minority populations. Risk stratification models and novel biomarkers are being developed to improve the efficiency of surveillance and identify patients at higher risk for HCC. In terms of prevention, some studies suggest that coffee consumption, bariatric surgery, metformin use, and low-dose aspirin may reduce the risk of HCC in patients with NAFLD. However, further studies are needed to validate these findings. In terms of treatment, the Barcelona Clinic Liver Cancer staging system is widely accepted for guiding treatment decisions. For early-stage HCC, radiofrequency ablation is the preferred ablative treatment, while resection is preferred for surgical candidates. Liver transplantation is also an option for eligible patients. In advanced-stage HCC, transarterial chemoembolization (TASE) is the main treatment modality, while systemic therapies such as immune checkpoint inhibitors and kinase inhibitors are available for patients who are not eligible for local-regional therapy. Overall, the outcomes for NAFLD-related HCC are similar to those for HCC related to other etiologies, and further research is needed to optimize surveillance and treatment strategies for this patient population.

Keywords

AASLD webinar

hepatocellular carcinoma

HCC

NAFLD

NASH

surveillance

cirrhosis

barriers to adherence

risk stratification models

treatment strategies