Kazuhisa Kodama1, Takumi Kawaguchi2, Hideyuki Hyogo3, Tomoaki Nakajima4, Masafumi Ono5, Masataka Seike6, Hirokazu Takahashi7, Yuichi Nozaki8, Miwa Kawanaka9, Saiyu Tanaka10, Kento Imajo11, Yoshio Sumida12, Yoshihiro Kamada13, Hideki Fujii14,15, Yuya Seko16, Tetsuo Takehara13, Yoshito Itoh16, Atsushi Nakajima11, Naohiko Masaki8, Takuji Torimura2, Toshiji Saibara5, Yoshiyasu Karino4, Kazuaki Chayama17, Katsutoshi Tokushige1. 1. Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 2. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan. 3. Department of Gastroenterology and Hepatology, JA Hiroshima General Hospital, Hatsukaichi, Japan. 4. Department of Hepatology, Sapporo Kosei General Hospital, Hokkaido, Japan. 5. Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan. 6. Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan. 7. Division of Hepatology, Liver Center, Saga Medical School, Saga, Japan. 8. Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan. 9. General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan. 10. Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan. 11. Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan. 12. Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan. 13. Department of Gastroenterology and Hepatology, Osaka University, Graduate School of Medicine, Osaka, Japan. 14. Department of Gastroenterology, Osaka City University, Osaka, Japan. 15. Department of Hepatology, Graduate School of Medicine, Osaka City University Osaka, Osaka, Japan. 16. Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan. 17. Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan.
Abstract
BACKGROUND AND AIM: The prevalence of hepatocellular carcinoma (HCC) associated with nonalcoholic fatty liver disease (NAFLD-HCC) is increasing. Unfortunately, NAFLD frequently develops into HCC without liver cirrhosis. Therefore, we investigated the clinical features of HCC in NAFLD patients without advanced fibrosis. METHODS: We compared clinical characteristics, survival rates, and recurrence rates between 104 NAFLD-HCC patients diagnosed between January 2000 and December 2016, including 35 without (F0-2) and 69 with advanced fibrosis (F3-F4). Risk factors associated with survival and recurrence were evaluated. RESULTS: In total, 66.3% of those diagnosed had advanced fibrosis, 58.8% in men and 80.5% in women (men vs women, P = 0.03). In NAFLD-HCC without advanced fibrosis, tumor size was significantly larger and liver histological activity was lower than those in patients with advanced fibrosis. Survival rates between the two groups did not differ. Among those achieving curative treatment, the recurrence rate was significantly lower in NAFLD-HCC without advanced fibrosis (P < 0.01). Risk factors of recurrence were male gender, lower serum albumin, and advanced fibrosis. CONCLUSIONS: In men, HCC tended to develop from NAFLD without advanced fibrosis. Although tumor size in NAFLD-HCC without advanced fibrosis is significantly larger, the recurrence rate is significantly lower. Surgical therapy should be strongly considered in these cases.
BACKGROUND AND AIM: The prevalence of hepatocellular carcinoma (HCC) associated with nonalcoholic fatty liver disease (NAFLD-HCC) is increasing. Unfortunately, NAFLD frequently develops into HCC without liver cirrhosis. Therefore, we investigated the clinical features of HCC in NAFLD patients without advanced fibrosis. METHODS: We compared clinical characteristics, survival rates, and recurrence rates between 104 NAFLD-HCC patients diagnosed between January 2000 and December 2016, including 35 without (F0-2) and 69 with advanced fibrosis (F3-F4). Risk factors associated with survival and recurrence were evaluated. RESULTS: In total, 66.3% of those diagnosed had advanced fibrosis, 58.8% in men and 80.5% in women (men vs women, P = 0.03). In NAFLD-HCC without advanced fibrosis, tumor size was significantly larger and liver histological activity was lower than those in patients with advanced fibrosis. Survival rates between the two groups did not differ. Among those achieving curative treatment, the recurrence rate was significantly lower in NAFLD-HCC without advanced fibrosis (P < 0.01). Risk factors of recurrence were male gender, lower serum albumin, and advanced fibrosis. CONCLUSIONS: In men, HCC tended to develop from NAFLD without advanced fibrosis. Although tumor size in NAFLD-HCC without advanced fibrosis is significantly larger, the recurrence rate is significantly lower. Surgical therapy should be strongly considered in these cases.
Authors: Vincent L Chen; Ming-Lun Yeh; Ju Dong Yang; Jennifer Leong; Daniel Q Huang; Hidenori Toyoda; Yao-Li Chen; Jennifer Guy; Mayumi Maeda; Pei-Chien Tsai; Chung-Feng Huang; Satoshi Yasuda; An K Le; Hansen Dang; Nasra H Giama; Hamdi A Ali; Ning Zhang; Xiaozhong Wang; Dae Won Jun; Cheng-Hao Tseng; Yao-Chun Hsu; Jee-Fu Huang; Chia-Yen Dai; Wan-Long Chuang; Qiang Zhu; Yock Young Dan; Myron Schwartz; Lewis R Roberts; Ming-Lung Yu; Mindie H Nguyen Journal: Hepatol Commun Date: 2020-09-24
Authors: Adrian T Billeter; Philip C Müller; Thomas Albrecht; Stephanie Roessler; Moritz Löffler; Anastasia Lemekhova; Arianeb Mehrabi; Beat P Müller-Stich; Katrin Hoffmann Journal: J Gastrointest Surg Date: 2020-05-06 Impact factor: 3.452