Background and Aim: Age and biological sex are risk factors for hepatocellular carcinoma (HCC) occurrence, but their impact on overall survival (OS) is a matter of debate. This study aims to investigate how sex and age at diagnosis, along with other associated factors (i.e., comorbidities, etiologies, therapy) impact OS in the HCC population. Method: Data from two HCC cohorts—a prospective registry from the University Hospital of Bern, Switzerland, and a retrospective registry from General Hospital Vienna, Austria—were combined and analyzed. Clinical and laboratory data were reviewed, and OS was compared using Kaplan-Meier curves and the log-rank test. Cox regression models with penalized splines were applied to examine how age at diagnosis influenced OS. Results: Of 1547 HCC patients, 1284 (84.1%) were male. Females were older (67 vs. 63 years, p < 0.001) and had lower rates of liver cirrhosis (p < 0.001), cardiac comorbidities (p < 0.001), and diabetes (p < 0.001). No significant difference in median OS between men and women was observed (18 months vs. 16 months, p = 0.304). Mortality risk increased with age, particularly between 60 and 70 years. However, after adjusting for treatment, the age effect became non-significant (p = 0.171). Conclusions: After controlling the model for therapy, neither age nor sex independently influenced OS in HCC patients, underscoring the impact of therapy on survival.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening drug reaction, which can affect multiple organs. Patients with DRESS syndrome and hepatic manifestations may present alterations ranging from mild hepatitis to acute liver failure. The diagnosis might be difficult, and the management of these patients is challenging. This report analyzes a series of five cases reporting the clinical presentation, which ranged from acute hepatitis to liver failure, and discussed their treatment.

Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment for complications of portal hypertension (variceal bleeding and refractory ascites). Sarcopenia affects 40–70% of patients with cirrhosis. We evaluated the improvement in sarcopenia after TIPS, the proportion of patients developing overt hepatic encephalopathy (HE) after TIPS and its association with sarcopenia, and the association between sarcopenia and mortality after TIPS. We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible studies included adults with cirrhosis and sarcopenia assessed by computed tomography (CT), using the skeletal muscle index (L3-SMI), or psoas muscle index (L3-PMI). We searched in eight databases for randomized trials, cohort studies, and case–control, cross-sectional, and case series studies. Twenty studies were included. The pooled prevalence of sarcopenia in patients with cirrhosis undergoing TIPS was 55.4% (95% CI 41.7–68.2%). Among these, sarcopenia improved in 57% of patients (95% CI 48–65%) after TIPS, with a mean L3-SMI increase of 4.53 cm²/m² (range: 2.4–6.9 cm²/m²). Sarcopenia was associated with higher odds of overt HE (pooled odds ration [OR] = 3.40, 95% CI 1.85–6.25, p <0.001) and a higher proportion of overt HE (43%, 95% CI 26–61%) than in patients without sarcopenia (12%, 95% CI 7–20%). The proportionate mortality after TIPS was 18.3% (95% CI 14.6–22.8%), across 6–33.6 months of follow-up. The association between sarcopenia and mortality was not significant (HR: 1.95, 95% CI 0.89–4.31, p = 0.078). In patients with cirrhosis and sarcopenia, TIPS is often followed by an improvement in sarcopenia. Sarcopenia is associated with higher odds of overt HE, whereas the effect of sarcopenia on mortality after TIPS remains uncertain. Sarcopenia affects over half of patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS) placement. This meta-analysis shows that TIPS is associated with sarcopenia improvement in >50% of patients, suggesting potential benefits beyond portal pressure reduction. Sarcopenia increases the risk of overt hepatic encephalopathy, whereas its effect on post-TIPS mortality remains inconclusive. These findings support routine assessment of sarcopenia to improve risk stratification and clinical decision-making. However, results should be interpreted cautiously because of study heterogeneity and the retrospective nature of the included data. Prospective studies are needed to confirm these findings and refine patient selection for TIPS.