The Risk of Decompensation in Steatotic Liver Disease-Related Hepatocellular Carcinoma: A Comparison with Viral-Controlled Cases.

IF 11.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver Cancer Pub Date : 2025-05-19 DOI:10.1159/000546492

Yuki Matsushita, Tatsuya Minami, Yoshikuni Kawaguchi, Akihiko Ichida, Ryo Oikawa, Keisuke Mabuchi, Makoto Moriyama, Tomoharu Yamada, Kazuya Okushin, Takuma Nakatsuka, Masaya Sato, Yotaro Kudo, Mitsuhiro Fujishiro, Kiyoshi Hasegawa, Ryosuke Tateishi

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引用次数: 0

Abstract

Background and aims: Treatment options for steatotic liver disease (SLD) are limited compared to those for viral hepatitis, which may affect the prognosis of patients with hepatocellular carcinoma (HCC).

Methods: This retrospective cohort study included 255 and 125 patients with SLD-related HCC and viral-controlled HCC (80 hepatitis C and 45 hepatitis B) who underwent curative radiofrequency ablation (RFA) for primary HCC (maximum tumor diameter ≤3 cm and ≤3 lesions). Viral control was defined as a sustained virological response to hepatitis C and undetectable hepatitis B viruses on a nucleos(t)ide analog before HCC diagnosis. Overall survival, recurrence rates, and hepatic decompensation rates were evaluated using the Kaplan-Meier method and Cox proportional hazard models between the two groups. Validation was performed in a surgical cohort of 120 patients (70 with SLD and 50 controls).

Results: The 1-, 3-, and 5-year survival rates were 97%, 81%, and 62% for patients with SLD-related HCC, and 100%, 94%, and 89% for viral-controlled patients in the RFA cohort, respectively (p < 0.001, log-rank test). Multivariate analysis showed no significant difference in recurrence between the two groups (adjusted hazard ratio [aHR] 1.06, p = 0.75); however, a higher risk of hepatic decompensation was observed in patients with SLD-related HCC (aHR 6.17; p < 0.001) and a worse overall survival (aHR 2.04; p = 0.003). Similar results were observed in the surgical cohort.

Conclusion: Patients with SLD-related HCC have a higher risk of decompensation than viral-controlled patients with HCC, which leads to a worse overall survival.

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脂肪变性肝病相关肝细胞癌代偿失代偿风险：与病毒控制病例的比较

背景和目的：与病毒性肝炎相比，脂肪变性肝病（SLD）的治疗选择有限，这可能会影响肝细胞癌（HCC）患者的预后。方法：本回顾性队列研究包括255和125例sld相关性HCC和病毒控制型HCC（80例丙型肝炎和45例乙型肝炎），这些患者接受了原发性HCC（最大肿瘤直径≤3cm，≤3个病变）的治疗性射频消融（RFA）。病毒控制被定义为在HCC诊断前对丙型肝炎和无法检测到的乙型肝炎病毒有持续的病毒学反应。采用Kaplan-Meier法和Cox比例风险模型对两组患者的总生存率、复发率和肝失代偿率进行评估。在120例手术队列患者（70例SLD患者和50例对照组）中进行了验证。结果：在RFA队列中，sld相关HCC患者的1年、3年和5年生存率分别为97%、81%和62%，病毒控制患者的1年、3年和5年生存率分别为100%、94%和89% （p < 0.001， log-rank检验）。多因素分析显示，两组患者复发率无显著差异（校正风险比[aHR] 1.06, p = 0.75）；然而，sld相关性HCC患者发生肝失代偿的风险更高(aHR 6.17；p < 0.001)，总生存期较差(aHR 2.04；P = 0.003)。在外科队列中也观察到类似的结果。结论：sld相关性HCC患者发生失代偿的风险高于病毒控制的HCC患者，导致总生存期差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver Cancer Medicine-Oncology

CiteScore

20.80

自引率

7.20%

发文量

审稿时长

16 weeks

期刊介绍： Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.