Non-alcoholic fatty liver disease (NAFLD) is expected to become a leading etiology of hepatocellular carcinoma (HCC)-related mortality in the United States.
HCC treatments with curative intent can improve survival in carefully selected patients.
Dr Lim and colleagues from Connecticut, USA compared survival after receipt of curative treatment for NAFLD and non-NAFLD-HCC etiologies, and by treatment was performed.
A cohort of 17,664 patients was assembled using linked Surveillance, Epidemiology, and End Results and Medicare data from 1991 to 2011 with confirmed diagnosis of HCC.
|The NAFLD group was 47% less likely to receive any curative treatment |
|Alimentary Pharmacology & Therapeutics|
The team reported that the cohort was mostly male, aged 70 years, without cardiovascular disease, and had liver cirrhosis without decompensation, metastatic HCC or large tumor size.
The researchers noted that the NAFLD-HCC group was mostly female and older with more cardiovascular disease, metastatic HCC, and large tumor size and less cirrhosis and decompensated liver disease than the non-NAFLD-HCC groups.
The team found that the NAFLD group was 47% less likely to receive any curative treatment as compared with non-NAFLD etiologies.
The researchers observed that NAFLD-HCC had worse median survival after OLT but had improved survival after resection as compared with non-NAFLD-HCC.
No significant survival differences existed for RFA by HCC etiology.
The team found that NAFLD was not an independent predictor of mortality after orthotopic liver transplantation, resection or RFA.
Dr Lim's team concludes, "Patients with NAFLD-HCC had worse survival after orthotopic liver transplantation but favorable survival after resection, particularly in the absence of cirrhosis, as compared with non-NAFLD-HCC etiologies."