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Resection of NAFLD/NASH-related Hepatocellular Carcinoma (HCC): Clinical Features and Outcomes Compared with HCC Due to Other Etiologies.
Pal Chaudhary, Surendra; Reyes, Stephanie; Chase, Matthew L; Govindan, Aparna; Zhao, Lei; Luther, Jay; Bhan, Irun; Bethea, Emily; Franses, Joseph W; Paige Walsh, Elizabeth; Anne Dageford, Leigh; Kimura, Shoko; Elias, Nahel; Yeh, Heidi; Markman, James; Bozorgzadeh, Adel; Tanabe, Kenneth; Ferrone, Cristina; Zhu, Andrew X; Andersson, Karin; Thiim, Michael; Antonio Catalano, Onofrio; Kambadakone, Avinash; Vagefi, Parsia A; Qadan, Motaz; Pratt, Daniel; Hashemi, Nikroo; Corey, Kathleen E; Misdraji, Joseph; Goyal, Lipika; Clark, Jeffrey W.
Affiliation
  • Pal Chaudhary S; Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA.
  • Reyes S; Duke University School of Medicine, Durham, NC, USA.
  • Chase ML; Beth Israel Deaconess Hospital, Needham, MA, USA.
  • Govindan A; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Zhao L; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Luther J; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Bhan I; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Bethea E; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Franses JW; Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA.
  • Paige Walsh E; Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA.
  • Anne Dageford L; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Kimura S; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Elias N; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Yeh H; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Markman J; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Bozorgzadeh A; Transplantation Unit, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Tanabe K; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Ferrone C; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Zhu AX; Jiahui Health, Jiahui International Cancer Center, Shanghai, People's Republic of China.
  • Andersson K; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Thiim M; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Antonio Catalano O; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Kambadakone A; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Vagefi PA; Division of Surgical Transplantation, University of Texas Southwestern, Dallas, TX, USA.
  • Qadan M; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Pratt D; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Hashemi N; Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
  • Corey KE; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • Misdraji J; Department of Pathology, Yale New Haven Hospital, Yale University, New Haven, CT, USA.
  • Goyal L; Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA.
  • Clark JW; Division of Oncology, Mass General Cancer Center and Harvard Medical School, Boston, MA, USA.
Oncologist ; 28(4): 341-350, 2023 04 06.
Article in En | MEDLINE | ID: mdl-36763374
ABSTRACT

BACKGROUND:

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies.

METHODS:

Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients.

RESULTS:

Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant.

CONCLUSIONS:

Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Hepatocellular / Non-alcoholic Fatty Liver Disease / Liver Neoplasms Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans Language: En Journal: Oncologist Journal subject: NEOPLASIAS Year: 2023 Document type: Article Affiliation country: United States
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Hepatocellular / Non-alcoholic Fatty Liver Disease / Liver Neoplasms Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans Language: En Journal: Oncologist Journal subject: NEOPLASIAS Year: 2023 Document type: Article Affiliation country: United States