RESUMO
INTRODUCTION AND OBJECTIVES: Autoimmune liver diseases (AILD) are rare causes hepatocellular carcinoma (HCC). and data on the efficacy and tolerability of anti-tumor therapies are scarce. This pan-European study aimed to assess outcomes in AILD-HCC patients treated with tyrosine kinase inhibitors (TKIs) or transarterial chemoembolization (TACE) compared with patients with more common HCC etiologies, including viral, alcoholic or non-alcoholic fatty liver disease. MATERIALS AND METHODS: 107 patients with HCC-AILD (AIH:55; PBC:52) treated at 13 European centres between 1996 and 2020 were included. 65 received TACE and 28 received TKI therapy. 43 (66â¯%) were female (median age 73 years) with HCC tumor stage BCLC A (34â¯%), B (46â¯%), C (9â¯%) or D (11â¯%). For each treatment type, propensity score matching was used to match AILD to non-AILD-HCC on a 1:1 basis, yielding in a final cohort of 130 TACE and 56 TKI patients for comparative analyses of median overall survival (mOS) and treatment tolerability. RESULTS: HCC-AILD patients showed comparable mOS to controls for both TACE (19.5â¯vs 22.1 months, pâ¯=â¯0.9) and TKI (15.4â¯vs 15.1 months, pâ¯=â¯0.5). Adverse events were less frequent in AILD-HCC patients than controls (33â¯%â¯% vs 62â¯%, pâ¯=â¯0.003). For TKIs, there were no significant differences in adverse events (73% vs. 86%, pâ¯=â¯0.2) or interruption rates (44% vs. 36â¯%, pâ¯=â¯0.7). CONCLUSIONS: In summary, this study demonstrates comparable mOS for AILD-HCC patients undergoing local and systemic treatments, with better tolerability than HCC of other causes. TKIs remain important therapeutic options for AILD-HCC patients, particularly given their exclusion from recent immunotherapy trials.