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Clinical features of hepatocellular carcinoma in nonalcoholic fatty liver disease patients without advanced fibrosis
Author(s) -
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 year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14608
Subject(s) - medicine , nonalcoholic fatty liver disease , hepatocellular carcinoma , cirrhosis , gastroenterology , fibrosis , fatty liver , disease
Abstract 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.