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Outcomes in Nonalcoholic Fatty Liver Disease–Associated HCC

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Key Points

  • Comorbidities were more common among patients with nonalcoholic fatty liver disease–associated HCC, and more intraoperative blood loss and postoperative complications as well as longer hospital stays were reported among these patients.
  • In patients with non–nonalcoholic fatty liver disease–associated HCC, researchers reported larger median tumor size, higher incidence of cirrhosis, and lower median neutrophil to lymphocyte ratio.
  • Five-year overall survival was better among patients with nonalcoholic fatty liver disease–associated HCC.

A recent study has found that nonalcoholic fatty liver disease–associated hepatocellular carcinoma (HCC) is associated with greater surgical morbidity and postresection liver failure, but long-term survival was better than in non–nonalcoholic fatty liver disease etiologies. These findings were published by Koh et al in the Journal of the American College of Surgeons.

Methods

This single-center study analyzed 996 patients who underwent liver resection for HCC. Patients were categorized as having nonalcoholic fatty liver disease–associated HCC (n = 152) or non–nonalcoholic fatty liver disease–associated HCC (n = 844) based on evidence of hepatic steatosis. Researchers then compared the two groups’ demographic, clinical, and surgical characteristics, as well as their postoperative complication rates and survival outcomes.

Findings

Comorbidities were more common among patients with nonalcoholic fatty liver disease–associated HCC, and more intraoperative blood loss and postoperative complications as well as longer hospital stays were reported among these patients. In patients with non–nonalcoholic fatty liver disease–associated HCC, researchers reported larger median tumor size, higher incidence of cirrhosis, and lower median neutrophil to lymphocyte ratio.

Five-year overall survival was better among patients with nonalcoholic fatty liver disease–associated HCC (P = .0355). However, patients with nonalcoholic fatty liver disease–associated HCC and abnormal parenchyma experienced poorer survival and 5-year overall survival.

Factors associated with poorer survival outcomes included age, congestive heart failure, Child B status, cirrhosis, tumor size, multinodularity, and R1 resection.

The authors concluded, “Nonalcoholic fatty liver disease–associated HCC is associated with greater surgical morbidity and post hepatectomy liver failure. Despite this, the long-term survival outcomes are favorable compared to non–nonalcoholic fatty liver disease etiologies.”

Disclosure: For full disclosures of the study authors, visit journalacs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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