Clinical trends in hepatocellular carcinoma from 2005 to 2019 with a focus on metabolic diseases: a German nationwide study.

IF 2.1 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

European Journal of Gastroenterology & Hepatology Pub Date : 2026-11-01 Epub Date: 2026-09-09 DOI:10.1097/MEG.0000000000003278

Josune Cabello, Wenyi Gu, Robert Schierwagen, Maximilian Joseph Brol, Frank Erhard Uschner, Martin Sebastian McCoy, Sabine Klein, Kai-Henrik Peiffer, Dominik Van de Loo, Andreas Pascher, Martina Holstein, Felix Becker, Haluk Morgül, Michael Köhler, Max Masthoff, Inga Grünewald, Klaus Wethmar, Dominik Heider, Michael Praktiknjo, Anton Gillessen, Florian Rennebaum, Jonel Trebicka

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引用次数: 0

Abstract

Introduction: Hepatocellular carcinoma (HCC) is the leading primary liver cancer and is associated with a high mortality rate. Liver cirrhosis represents the main risk factor for HCC; however, its underlying etiologies have shifted over the last decade. This German population-based study investigated the effects of the changing trends on etiologies of HCC hospital admissions.

Methods: We analyzed 369 369 HCC-admissions in German hospitals from 2005 to 2019 based on the diagnosis-related groups via German International Classification of Diseases and Operation and Procedure key System codes. Temporal trends and associations were assessed using linear and multivariate logistic regression.

Results: HCC admissions increased significantly by 21.8%, from 19 594 in 2005 to 25 899 in 2019, while the in-hospital mortality rate decreased from 13.6 to 10.8%. The most common underlying etiology was alcohol-related liver disease (ALD), accounting for 55.5% of all HCC etiologies, followed by viral hepatitis (32.3%). While admissions of patients with ALD increased by 34.5% from 4008 to 5392, viral hepatitis declined significantly from 3532 to 1580. Metabolic dysfunction-associated steatotic liver disease (MASLD) underlying for HCC represented 4.5%, but exhibited the strongest increase of 3.7-fold among all etiologies. The in-hospital mortality rate of ALD-associated HCC decreased from 15.3 to 11.6%, whereas in viral hepatitis-associated HCC, it remained more similar (11.5 vs. 11.0%). Cardiometabolic risk factors significantly increased in HCC admissions over time ( P < 0.001). Furthermore, HCC admissions exhibited a greater burden of metabolic comorbidities than other malignancies.

Conclusions: This study highlights the increase in underlying ALD, MASLD, and metabolic risk factors in HCC admissions. Especially, cardiometabolic risk factors appear to play a significant role as drivers of hospital admissions in patients with HCC.

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2005年至2019年以代谢性疾病为重点的肝细胞癌临床趋势：一项德国全国性研究

肝细胞癌（HCC）是主要的原发性肝癌，具有很高的死亡率。肝硬化是HCC的主要危险因素；然而，其潜在的病因在过去十年中发生了变化。这项以德国人群为基础的研究调查了HCC入院病因变化趋势的影响。方法：通过德国国际疾病分类和操作程序关键系统代码，对2005 - 2019年德国医院就诊的369 369例hcc患者进行诊断相关分组分析。使用线性和多元逻辑回归评估时间趋势和关联。结果：HCC住院人数从2005年的19594人增加到2019年的25899人，显著增加21.8%，住院死亡率从13.6%下降到10.8%。最常见的潜在病因是酒精相关性肝病（ALD），占所有HCC病因的55.5%，其次是病毒性肝炎（32.3%）。而入院的ALD患者从4008人增加到5392人，增加了34.5%，病毒性肝炎从3532人显著下降到1580人。HCC潜在的代谢功能障碍相关脂肪变性肝病（MASLD）占4.5%，但在所有病因中表现出3.7倍的最强增长。ald相关HCC的住院死亡率从15.3%降至11.6%，而病毒性肝炎相关HCC的住院死亡率保持相似（11.5% vs 11.0%）。随着时间的推移，HCC入院患者的心脏代谢危险因素显著增加（P < 0.001）。此外，HCC入院比其他恶性肿瘤表现出更大的代谢合并症负担。结论：本研究强调了HCC入院患者中潜在的ALD、MASLD和代谢危险因素的增加。特别是，心脏代谢危险因素似乎在HCC患者住院的驱动因素中起着重要作用。

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

European Journal of Gastroenterology & Hepatology 医学-胃肠肝病学

CiteScore

4.40

自引率

4.80%

发文量

269

审稿时长

1 months

期刊介绍： European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology. The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.