Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease
Background. Nonalcoholic fatty liver disease (NAFLD) may develop into liver cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to compare the clinical patterns and survival outcomes of NAFLD-related HCC patients and those of alcoholic liver disease (ALD)-related or hepatitis B v...
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| Language: | English |
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Wiley
2020-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2020/4873875 |
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| author | Seon Young Ahn Suk Bae Kim Il Han Song |
| author_facet | Seon Young Ahn Suk Bae Kim Il Han Song |
| author_sort | Seon Young Ahn |
| collection | DOAJ |
| description | Background. Nonalcoholic fatty liver disease (NAFLD) may develop into liver cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to compare the clinical patterns and survival outcomes of NAFLD-related HCC patients and those of alcoholic liver disease (ALD)-related or hepatitis B virus (HBV)-related HCC patients. Methods. A total of 622 HCC patients with associated NAFLD (n = 56), ALD (n = 173), or HBV infection (n = 393) were enrolled. The clinical characteristics and survival were analyzed according to the underlying liver diseases. Results. NAFLD-related HCC patients were more commonly older women and had more metabolic risk factors but were less likely to have cirrhosis and ascites, compared to ALD-related or HBV-related HCC patients. NAFLD-related HCC more often had an infiltrative pattern (P=0.047), a larger tumor (P=0.001), more macrovascular invasion (P=0.022), and exceeded the Milan criteria (P=0.001), but was less frequently diagnosed during tumor surveillance (P=0.025). Survival analysis did not show any difference among NAFLD-related, ALD-related, and HBV-related HCC patients. Furthermore, propensity score matching analysis did not reveal a significant difference in the median survival between the different groups (NAFLD vs. ALD, 14.0 months [95% confidence interval (CI), 2.0–26.0] vs. 13.0 months [95% CI, 0–26.3]; P=0.667, NAFLD vs. HBV, 14.0 months [95% CI, 2.0–26.0] vs. 12.0 months [95% CI, 4.3–17.8]; P=0.573). Conclusions. NAFLD-related HCCs were more often detected at an advanced stage with infiltrative patterns, although they showed no significant difference in survival compared to ALD-related or HBV-related HCCs. A future prospective research should be focused on identifying NAFLD patients who require strict surveillance in order to early detect and timely treat HCC. |
| format | Article |
| id | doaj-art-6808cbe48de943e3975fdd1b29fb7a9e |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-6808cbe48de943e3975fdd1b29fb7a9e2025-02-03T06:44:00ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/48738754873875Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver DiseaseSeon Young Ahn0Suk Bae Kim1Il Han Song2Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan, Chungcheongnam-do 31116, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan, Chungcheongnam-do 31116, Republic of KoreaDivision of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, 201 Manghyang-ro, Dongnam-gu, Cheonan, Chungcheongnam-do 31116, Republic of KoreaBackground. Nonalcoholic fatty liver disease (NAFLD) may develop into liver cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to compare the clinical patterns and survival outcomes of NAFLD-related HCC patients and those of alcoholic liver disease (ALD)-related or hepatitis B virus (HBV)-related HCC patients. Methods. A total of 622 HCC patients with associated NAFLD (n = 56), ALD (n = 173), or HBV infection (n = 393) were enrolled. The clinical characteristics and survival were analyzed according to the underlying liver diseases. Results. NAFLD-related HCC patients were more commonly older women and had more metabolic risk factors but were less likely to have cirrhosis and ascites, compared to ALD-related or HBV-related HCC patients. NAFLD-related HCC more often had an infiltrative pattern (P=0.047), a larger tumor (P=0.001), more macrovascular invasion (P=0.022), and exceeded the Milan criteria (P=0.001), but was less frequently diagnosed during tumor surveillance (P=0.025). Survival analysis did not show any difference among NAFLD-related, ALD-related, and HBV-related HCC patients. Furthermore, propensity score matching analysis did not reveal a significant difference in the median survival between the different groups (NAFLD vs. ALD, 14.0 months [95% confidence interval (CI), 2.0–26.0] vs. 13.0 months [95% CI, 0–26.3]; P=0.667, NAFLD vs. HBV, 14.0 months [95% CI, 2.0–26.0] vs. 12.0 months [95% CI, 4.3–17.8]; P=0.573). Conclusions. NAFLD-related HCCs were more often detected at an advanced stage with infiltrative patterns, although they showed no significant difference in survival compared to ALD-related or HBV-related HCCs. A future prospective research should be focused on identifying NAFLD patients who require strict surveillance in order to early detect and timely treat HCC.http://dx.doi.org/10.1155/2020/4873875 |
| spellingShingle | Seon Young Ahn Suk Bae Kim Il Han Song Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease Canadian Journal of Gastroenterology and Hepatology |
| title | Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease |
| title_full | Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease |
| title_fullStr | Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease |
| title_full_unstemmed | Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease |
| title_short | Clinical Patterns and Outcome of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease |
| title_sort | clinical patterns and outcome of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease |
| url | http://dx.doi.org/10.1155/2020/4873875 |
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