Liver Resection for Nonalcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma

Koh, Ye‐Xin; Tan, Hiang Jin; Liew, Yi Xin; Syn, Nicholas; Teo, Jin Yao; Lee, Ser Yee; Goh, Brian K.P.; Goh, George Boon‐Bee; Chan, Chung Yip

doi:10.1016/j.jamcollsurg.2019.07.012

Cited by 38 publications

(40 citation statements)

References 26 publications

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“…Other studies have shown a higher peri-/postoperative complication rate, including post-hepatectomy liver failure and 30-day mortality, in NAFLD-associated HCC when compared with non-NAFLD-related HCC [61,73]. In contrast, resection of NAFLD/MS-associated HCC showed favorable long-term survival compared with non-NAFLD-associated HCC [61,68,73]. However, a study comparing NAFLD-associated HCC and HBV-associated HCC showed no difference in survival [69].…”

Section: Liver Resectionmentioning

confidence: 92%

“…When performing a liver resection, NAFLD is a burden for serious postoperative complications and liver failure [60][61][62]. After liver resection, the remaining liver volume must be sufficient to ensure adequate liver function.…”

Section: Implications For Surgerymentioning

confidence: 99%

“…Dysfunctional lipid metabolism, a characteristic in NAFLD, hinders liver regeneration. Various in vivo studies of partial hepatectomy and liver resection have shown that NAFLD reduces liver regeneration capacity and proliferation [61,62,[64][65][66][67]. It is, therefore, important to carefully assess NAFLD in the preoperative setting.…”

Section: Implications For Surgerymentioning

confidence: 99%

“…Studies have shown no difference in reported perioperative morbidity and mortality between HCC caused by either NAFLD, HBV, HCV, or MS [69,72]. Other studies have shown a higher peri-/postoperative complication rate, including post-hepatectomy liver failure and 30-day mortality, in NAFLD-associated HCC when compared with non-NAFLD-related HCC [61,73]. In contrast, resection of NAFLD/MS-associated HCC showed favorable long-term survival compared with non-NAFLD-associated HCC [61,68,73].…”

Section: Liver Resectionmentioning

confidence: 99%

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Mechanisms of nonalcoholic fatty liver disease and implications for surgery

Kaufmann

Reca

Wang

et al. 2020

Langenbecks Arch Surg

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Background Nonalcoholic fatty liver disease (NAFLD) has become the most common form of chronic liver disease in both adults and children worldwide. Understanding the pathogenic mechanisms behind NAFLD provides the basis for identifying risk factors, such as metabolic syndrome, pancreatoduodenectomy, and host genetics, that lead to the onset and progression of the disease. The progression from steatosis to more severe forms, such as steatohepatitis, fibrosis, and cirrhosis, leads to an increased number of liver and non-liver complications. Purpose NAFLD-associated end-stage liver disease (ESLD) and hepatocellular carcinoma (HCC) often require surgery as the only curative treatment. In particular, the presence of NAFLD together with the coexisting metabolic comorbidities that usually occur in these patients requires careful preoperative diagnosis and peri-/postoperative management. Bariatric surgery, liver resection, and liver transplantation (LT) have shown favorable results for weight loss, HCC, and ESLD in patients with NAFLD. The LT demand and the increasing spread of NAFLD in the donor pool reinforce the already existing lack of donor organs. Conclusion In this review, we will discuss the diverse mechanisms underlying NAFLD, its implications for surgery, and the challenges for patient management.

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Section: Liver Resectionmentioning

confidence: 92%

Section: Implications For Surgerymentioning

confidence: 99%

Section: Implications For Surgerymentioning

confidence: 99%

Section: Liver Resectionmentioning

confidence: 99%

See 2 more Smart Citations

Mechanisms of nonalcoholic fatty liver disease and implications for surgery

Kaufmann

Reca

Wang

et al. 2020

Langenbecks Arch Surg

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show abstract

“…Given that NAFLD-associated HCC patients have shown similar recurrence-free survival as other etiology-related HCC, it is conceivable that the recurrence rate is quite high. 13,14 If the recurrence rate is so high, how long and how often should we follow up on HCC patients without established risk factors? To date, there has been a lack of guidelines on the follow-up strategies for HCC cases from any etiology.…”

Section: Dear Editormentioning

confidence: 99%

How long should physicians follow up with patients after curative treatment for hepatocellular carcinoma?

Kim

2020

Clin Mol Hepatol

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Comparative analysis of perioperative and long‐term outcomes of patients with hepatocellular carcinoma: Nonalcoholic fatty liver disease versus viral hepatitis

Matsumoto,

Shiraki,

Tanaka

et al. 2024

World j. surg.

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BackgroundDespite the accumulating evidence regarding the oncological differences between nonalcoholic fatty liver disease (NAFLD)‐related hepatocellular carcinoma (HCC) and viral infection‐related HCC, the short‐ and long‐term outcomes of surgical resection of NAFLD‐related HCC remain unclear. While some reports indicate improved postoperative survival in NAFLD‐related HCC, other studies suggest higher postoperative complications in these patients.MethodsPatients with NAFLD and those with hepatitis viral infection who underwent hepatectomy for HCC at our department were retrospectively analyzed. The clinical, surgical, pathological, and survival outcomes were compared between the two groups.ResultsAmong the 1047 consecutive patients who underwent hepatectomy for HCC, 57 had NAFLD‐related HCC (NAFLD group), and 727 had virus‐related HCC (VH group). The body mass index and serum glycated hemoglobin levels were significantly higher in the NAFLD group than in the VH group. There were no significant differences in operative time and bleeding amount. Moreover, the morbidity and the length of postoperative hospital stays were similar across both groups. The pathological results showed that the tumor size was significantly larger in the NAFLD group than in the VH group. No significant differences between the groups in overall or recurrence‐free survival were found. In a subgroup analysis with matched tumor diameters, patients in the NAFLD group had a better prognosis after hepatectomy than those in the VH group.ConclusionSurgical outcomes after hepatectomy were comparable between the groups. Subgroup analysis reveals early detection and surgical intervention in NAFLD‐HCC may improve prognosis.

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Liver Resection for Nonalcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma

Cited by 38 publications

References 26 publications

Mechanisms of nonalcoholic fatty liver disease and implications for surgery

Mechanisms of nonalcoholic fatty liver disease and implications for surgery

How long should physicians follow up with patients after curative treatment for hepatocellular carcinoma?

Comparative analysis of perioperative and long‐term outcomes of patients with hepatocellular carcinoma: Nonalcoholic fatty liver disease versus viral hepatitis

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