Resolution of MASH with no worsening of fibrosis after bariatric surgery improves 15-year survival: a prospective cohort study.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Guillaume Lassailly, Robert Caiazzo, Armelle Goemans, Mikael Chetboun, Viviane Gnemmi, Julien Labreuche, Gregory Baud, Helene Verkindt, Camille Marciniak, Naima Oukhouya-Daoud, Line-Carolle Ntandja-Wandji, Massih Ningarhari, Emmanuelle Leteurtre, Violeta Raverdy, Sébastien Dharancy, Alexandre Louvet, François Pattou, Philippe Mathurin
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引用次数: 0

Abstract

Objectives: Investigate the consequences of the histological progression of metabolically associated steatohepatitis (MASH) and fibrosis on long-term survival after bariatric surgery.

Methods: From 1994 to 2021, 3028 patients at the University Hospital of Lille were prospectively included. Baseline liver biopsies were systematically performed with proposed follow-up biopsies 1 year after surgery, mainly in MASH patients. We evaluated the association of the baseline and 1-year histological progression of MASH and fibrosis status and long-term survival using Cox regression models.

Results: At baseline, 2641 patients had a biopsy (89%), including 232 with MASH (8.7%) and 266 (10.8%) with significant fibrosis (grade F2-F4). The median follow-up was 10.1 years. At 1 year, 594 patients had qualitative paired biopsies. Survival was shorter at the 15-year follow-up in patients with baseline MASH, than in those without (hazard ratio (HR), 2.21; 95% confidence interval (CI), 1.38 to 3.53) and in F2-F4 than in F0-F1 (HR, 3.38; (95%CI, 2.24 to 5.10). At the 1-year landmark analysis, compared to patients without baseline MASH, mortality increased in those with persistent MASH and/or if fibrosis worsened (adjusted HR, 2.54 (95% CI, 1.06 to 6.10), but not if MASH resolved without the worsening of fibrosis (adjusted HR, 0.73 (95% CI, 0.28 to 1.87). Similarly, compared to patients without significant fibrosis at baseline, patients with persistent significant fibrosis had increased mortality (adjusted HR, 4.03 [95% CI, 1.86 to 8.72]) but not if fibrosis improved from F2-F4 to F0-F1 (adjusted HR; 1.49; 95%CI, 0.52 to 4.24).

Conclusion: Histological remission of MASH or significant fibrosis improves survival after bariatric surgery.

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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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