TY - JOUR
T1 - Resection of NAFLD/NASH-related Hepatocellular Carcinoma (HCC)
T2 - Clinical Features and Outcomes Compared with HCC Due to Other Etiologies
AU - Chaudhary, Surendra Pal
AU - Reyes, Stephanie
AU - Chase, Matthew L.
AU - Govindan, Aparna
AU - Zhao, Lei
AU - Luther, Jay
AU - Bhan, Irun
AU - Bethea, Emily
AU - Franses, Joseph W.
AU - Walsh, Elizabeth Paige
AU - Dageford, Leigh Anne
AU - Kimura, Shoko
AU - Elias, Nahel
AU - Yeh, Heidi
AU - Markman, James
AU - Bozorgzadeh, Adel
AU - Tanabe, Kenneth
AU - Ferrone, Cristina
AU - Zhu, Andrew X.
AU - Andersson, Karin
AU - Thiim, Michael
AU - Catalano, Onofrio Antonio
AU - Kambadakone, Avinash
AU - Vagefi, Parsia A.
AU - Qadan, Motaz
AU - Pratt, Daniel
AU - Hashemi, Nikroo
AU - Corey, Kathleen E.
AU - Misdraji, Joseph
AU - Goyal, Lipika
AU - Clark, Jeffrey W.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/4
Y1 - 2023/4
N2 - Background: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies. Methods: Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients. Results: Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant. Conclusions: Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.
AB - Background: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies. Methods: Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients. Results: Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant. Conclusions: Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.
KW - NAFLD
KW - NASH
KW - hepatocellular carcinoma
KW - metabolic syndrome
KW - outcome
KW - steatohepatitis
UR - http://www.scopus.com/inward/record.url?scp=85152165190&partnerID=8YFLogxK
U2 - 10.1093/oncolo/oyac251
DO - 10.1093/oncolo/oyac251
M3 - Article
C2 - 36763374
AN - SCOPUS:85152165190
SN - 1083-7159
VL - 28
SP - 341
EP - 350
JO - Oncologist
JF - Oncologist
IS - 4
ER -