Clinical Course and Outcomes of Patients with Nonalcoholic Fatty Liver Disease-Related Hepatocellular Cancer (NAFLD-HCC)

Chu, Jinna; Cholankeril, George; Xin, Yu; Rana, Abbas; Natarajan, Yamini; El–Serag, Hashem B.; Kramer, Jennifer R.; Kanwal, Fasiha

doi:10.1007/s10620-022-07565-x

Cited by 5 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, we expected the majority of patients in the all-negative group would have NAFLD-related HCC. A recent study reported that among NAFLD-related HCC patients, most mortality (72.2% at 3 years) was attributable to HCC, although, among NAFLD-related HCC patients who underwent curative treatment, non-HCC-related mortality accounted for 40% of all deaths between 3 and 5 years after treatment [ 5 ]. In the current study, 62.2% of all death in the all-negative group were attributable to HCC at 3 years, and non-HCC-related mortality accounted for 37.5%–38.5% of all deaths between 3 and 5 years following curative treatment in the all-negative group, which is comparable to the previous study [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple comorbidity indices (e.g., the cirrhosis-related comorbidity score, the National Cancer Institute Comorbidity Index, etc.) have been shown to have value for predicting mortality among HCC patients [ 5 , 19 ]. In the current study, we used older age (75 years or older) as a simple and objective surrogate for severe comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…All-cause mortality was driven by non-HCC-related mortality in patients 75 years and older who underwent curative treatments, as the cumulative number of non-HCC-related deaths was higher than HCC-related deaths during the treatment follow-up period. This study enrolled patients treated by the VA, who were mostly men, limiting the generalizability of study findings to women with NAFLD-related HCC [ 5 ]. Furthermore, the proportion of non-HCC-related deaths that occur among patients with NAFLD-related HCC compared with other chronic liver disease (CLD) etiologies remains unclear.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Causes of Death among Patients with Hepatocellular Carcinoma According to Chronic Liver Disease Etiology

Yen

Kee

et al. 2023

Cancers

View full text Add to dashboard Cite

This study was conducted to determine whether the causes of death among patients with hepatocellular carcinoma (HCC) differ according to chronic liver disease (CLD) etiology. Between 2011 and 2020, 3977 patients who were newly diagnosed with HCC at our institution were enrolled in this study. We determined whether the cause of death was HCC-related and non-HCC-related. For patients with multiple CLD etiologies, etiology was classified using the following hierarchy: hepatitis C virus (HCV) > hepatitis B virus (HBV) > alcohol-related causes > all negative. All negative was defined as negative for HCV, HBV, and alcohol-related causes. Among 3977 patients, 1415 patients were classified as HCV-related, 1691 patients were HBV-related, 145 patients were alcohol-related, and 725 patients were all negative. HCC-related mortality was the leading cause of death, irrespective of etiology. Among patients who underwent curative treatment, HCC-related mortality was the leading cause of death for patients in the HCV, HBV, and all-negative groups, but not for patients in the alcohol-related group. Among patients 75 years and older who underwent curative treatment, HCC-related mortality was the leading cause of death in the HCV but not HBV or all-negative groups. In conclusion, although most patients with HCC die due to HCC-related causes, non-HCC-related mortality represents a competing event in certain patient subgroups. The current study results underscore the importance of assessing and managing underlying comorbidities, particularly among patients with HCC at risk of non-HCC-related mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Causes of Death among Patients with Hepatocellular Carcinoma According to Chronic Liver Disease Etiology

Yen

Kee

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…Although cardiovascular disease is the leading cause of death in patients with NAFLD, accounting for 25-43% of deaths, liver-related mortality remains the leading cause in those with cirrhosis. [82,83] Even so, in a Swedish cohort study with 537 patients with biopsy proven cirrhosis from NAFLD, Simon et al demonstrated that cirrhosis from NAFLD still carried an excess risk for mortality for extrahepatic cancer (adjusted hazard ratio [HR], 2.12, 95% CI, 1.58-2.84) and cardiovascular disease (adjusted HR, 2.11, 95% CI, 1.63-2.73) than the general population. [84] To date, there are no prospective data on cause-specific mortality in patients with HCC from NAFLD.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Approximately 80% of patients presented with advanced HCC, but non-HCC mortality was a clinically meaningful competing event for patients undergoing curative treatment (30.2% of deaths) and early-stage HCC (41.7%). [82] Current Recommendations for HCC surveillance in NAFLD Patients…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Current Challenges and Future Direction in Surveillance for Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease

Cholankeril

El–Serag

2022

Semin Liver Dis

Self Cite

View full text Add to dashboard Cite

The burden for hepatocellular carcinoma (HCC) attributed to nonalcoholic fatty liver disease (NAFLD) continues to grow in parallel with rising global trends in obesity. The risk of HCC is elevated among patients with NAFLD-related cirrhosis to a level that justify surveillance based on cost-effectiveness argument. The quality of current evidence for HCC surveillance in all patients with chronic liver disease is poor, and even lower in those with NAFLD. For a lack of more precise risk-stratification tools, current approaches to defining a target population in non-cirrhotic NAFLD are limited to noninvasive tests for liver fibrosis, as a proxy for liver-related morbidity and mortality. Beyond etiology and severity of liver disease, traditional and metabolic risk factors, such as diabetes mellitus, older age, male gender and tobacco smoking, are not enough for HCC risk stratification for surveillance efficacy and effectiveness in NAFLD. There is an association between molecular and genetic factors and HCC risk in NAFLD, and risk models integrating both clinical and genetic factors will be key to personalizing HCC risk. Herein in this review, we discuss concerns regarding defining a target population, surveillance test accuracy, surveillance underuse, and other cost-effective considerations for HCC surveillance in individuals with NAFLD.

show abstract

MAFLD in adults: non-invasive tests for diagnosis and monitoring of MAFLD

Chan,

Wong,

Adams

et al. 2024

Hepatol Int

View full text Add to dashboard Cite

Clinical Course and Outcomes of Patients with Nonalcoholic Fatty Liver Disease-Related Hepatocellular Cancer (NAFLD-HCC)

Cited by 5 publications

References 34 publications

Causes of Death among Patients with Hepatocellular Carcinoma According to Chronic Liver Disease Etiology

Causes of Death among Patients with Hepatocellular Carcinoma According to Chronic Liver Disease Etiology

Current Challenges and Future Direction in Surveillance for Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease

MAFLD in adults: non-invasive tests for diagnosis and monitoring of MAFLD

Contact Info

Product

Resources

About