ONO Masafumi
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Clinical features of hepatocellular carcinoma in nonalcoholic fatty liver disease patients without advanced fibrosis.
Journal Formal name：Journal of gastroenterology and hepatology
Abbreviation：J Gastroenterol Hepatol
ISSN code：14401746/08159319
Domestic / ForeginForegin
Volume, Issue, Page 34(9),pp.1626-1632
Author and coauthor Kodama Kazuhisa, Kawaguchi Takumi, Hyogo Hideyuki, Nakajima Tomoaki, Ono Masafumi, Seike Masataka, Takahashi Hirokazu, Nozaki Yuichi, Kawanaka Miwa, Tanaka Saiyu, Imajo Kento, Sumida Yoshio, Kamada Yoshihiro, Fujii Hideki, Seko Yuya, Takehara Tetsuo, Itoh Yoshito, Nakajima Atsushi, Masaki Naohiko, Torimura Takuji, Saibara Toshiji, Karino Yoshiyasu, Chayama Kazuaki, Tokushige Katsutoshi
Publication date 2019/09
Summary BACKGROUND AND AIM:The prevalence of hepatocellular carcinoma (HCC) associated with nonalcoholic fatty liver disease (NAFLD-HCC) is increasing. Unfortunately, NAFLD frequently develops into HCC without liver cirrhosis. Therefore, we investigated the clinical features of HCC in NAFLD patients without advanced fibrosis.METHODS:We compared clinical characteristics, survival rates, and recurrence rates between 104 NAFLD-HCC patients diagnosed between January 2000 and December 2016, including 35 without (F0-2) and 69 with advanced fibrosis (F3-F4). Risk factors associated with survival and recurrence were evaluated.RESULTS:In total, 66.3% of those diagnosed had advanced fibrosis, 58.8% in men and 80.5% in women (men vs women, P = 0.03). In NAFLD-HCC without advanced fibrosis, tumor size was significantly larger and liver histological activity was lower than those in patients with advanced fibrosis. Survival rates between the two groups did not differ. Among those achieving curative treatment, the recurrence rate was significantly lower in NAFLD-HCC without advanced fibrosis (P < 0.01). Risk factors of recurrence were male gender, lower serum albumin, and advanced fibrosis.CONCLUSIONS:In men, HCC tended to develop from NAFLD without advanced fibrosis. Although tumor size in NAFLD-HCC without advanced fibrosis is significantly larger, the recurrence rate is significantly lower. Surgical therapy should be strongly considered in these cases.
DOI 10.1111/jgh.14608
PMID 30668889