Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma worldwide.
NAFLD-hepatocellular carcinoma often occurs in non-cirrhotic liver raising important surveillance issues.
Professor Ratziu and colleagues from France determined the temporal trends for prevalence, clinical characteristics and outcomes of NAFLD-hepatocellular carcinoma in patients undergoing liver resection.
Consecutive patients with histologically confirmed hepatocellular carcinoma who underwent liver resection over a 20-year period.
NAFLD was diagnosed based on past or present exposure to obesity or diabetes without other causes of chronic liver disease.
|A total of 53% patients had tumor recurrence|
|Alimentary Pharmacology & Therapeutics|
The research team included a total of 323 hepatocellular carcinoma patients, 12% with NAFLD.
From 1995-1999 to 2010-2014, the prevalence of NAFLD-hepatocellular carcinoma increased from 3% to 20%, respectively, and followed the temporal trends in the prevalence of metabolic risk factors, while hepatitis C-hepatocellular carcinoma decreased.
NAFLD-hepatocellular carcinoma occurred more frequently in the absence of bridging fibrosis/cirrhosis.
Within the NAFLD group, tumor characteristics were similar between F0-F2 and F3-F4 patients, except for a higher proportion of single nodules.
The researchers found that a total of 53% patients had tumor recurrence, and 40% died.
NAFLD-hepatocellular carcinoma had similar time to recurrence and survival as hepatocellular carcinoma of other etiologies.
Satellite nodules, tumor size, microvascular invasion and male sex but not the etiology were independently associated with recurrence.
Professor Ratziu's team concludes, "Non-alcoholic fatty liver disease increased substantially over the past 20 years among resectable hepatocellular carcinoma."
"It is now the leading cause of hepatocellular carcinoma occuring without/or with only minimal fibrosis."
"NAFLD patients are older, with larger tumors while survival and recurrence rates are as severe as in other etiologies."