Characteristics of Liver Cancer Associated with Nonalcoholic Fatty Liver

Liver cancers(hepatocellular carcinoma, HCC) have 2 main causes: hepatitis B-C infections and alcohol. However, obesity is also a cause of liver cancer, and as obesity has become more widespread than ever before in human history, obesity has begun to become one of the main causes of liver cancer.

A recent study found that nonalcoholic fatty liver disease -associated hepatocellular carcinoma (HCC) was associated with greater surgical morbidity/complications and postoperative liver failure, but long-term survival was better than for liver cancers not associated with nonalcoholic fatty liver disease. These findings were published by Koh and colleagues in the Journal of the American College of Surgeons.

Details of the Study

This single-center study analyzed 996 patients who underwent liver tumor surgery for hepatocellular carcinoma. Based on findings of hepatic steatosis (fatty liver), patients were classified into 152 hepatocellular carcinoma patients associated with nonalcoholic fatty liver disease and 844 hepatocellular carcinoma patients not associated with nonalcoholic fatty liver disease. The researchers then compared the demographic, clinical and surgical characteristics of the two groups, as well as postoperative complication rates and survival outcomes.

Findings

Comorbidities (coexisting diseases and problems) were more common in patients with nonalcoholic fatty liver disease-associated hepatocellular carcinoma (HCC), and greater intraoperative blood loss and postoperative complications, as well as longer hospital stays, were reported in these patients. In patients with nonalcoholic fatty liver disease-associated HCC, the researchers reported a larger median tumor size, a higher frequency of cirrhosis and a lower median neutrophil / lymphocyte ratio.

Five-year overall survival, was better in patients with nonalcoholic fatty liver disease-associated HCC. However, patients with nonalcoholic fatty liver disease-associated HCC and abnormal liver tissue had worse 5-year overall survival.

Factors associated with shorter survival outcomes were age, congestive heart failure, chil B status (a type of liver failure classification), cirrhosis, tumor size, multinodularity and R1 resection (incomplete surgical removal of the tumor).

The study authors "Nonalcoholic fatty liver disease-associated HCC was associated with greater surgical morbidity and liver failure after hepatectomy (removal of liver tissue). Nevertheless, long-term survival outcomes are more favorable compared with liver cancers due to causes other than nonalcoholic fatty liver disease." stated.

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