{"doi":"10.1093/oncolo/oyac251","title":"Resection of NAFLD/NASH-related Hepatocellular Carcinoma (HCC): Clinical Features and Outcomes Compared with HCC Due to Other Etiologies","abstract":"BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are the leading causes of hepatocellular carcinoma (HCC) worldwide. Limited data exist on surgical outcomes for NAFLD/NASH-related HCC compared with other HCC etiologies. We evaluated differences in clinicopathological characteristics and outcomes of patients undergoing surgical resection for NAFLD/NASH-associated HCC compared with other HCC etiologies. METHODS: Demographic, clinicopathological features, and survival outcomes of patients with surgically resected HCC were collected. NAFLD activity score (NAS) and fibrosis score were assessed by focused pathologic review in a subset of patients. RESULTS: Among 492 patients screened, 260 met eligibility (NAFLD/NASH [n = 110], and other etiologies [n = 150]). Median age at diagnosis was higher in the NAFLD/NASH HCC cohort compared with the other etiologies cohort (66.7 vs. 63.4 years, respectively, P = .005), with an increased percentage of female patients (36% vs. 18%, P = .001). NAFLD/NASH-related tumors were more commonly >5 cm (66.0% vs. 45%, P = .001). There were no significant differences in rates of lymphovascular or perineural invasion, histologic grade, or serum AFP levels. The NAFLD/NASH cohort had lower rates of background liver fibrosis, lower AST and ALT levels, and higher platelet counts (P < .01 for all). Median overall survival (OS) was numerically shorter in NAFLD/NASH vs other etiology groups, however, not statistically significant. CONCLUSIONS: Patients with NAFLD/NASH-related HCC more commonly lacked liver fibrosis and presented with larger HCCs compared with patients with HCC from other etiologies. No differences were seen in rates of other high-risk features or survival. With the caveat of sample size and retrospective analysis, this supports a similar decision-making approach regarding surgical resection for NAFLD/NASH and other etiology-related HCCs.","journal":"The Oncologist","year":2023,"id":333651,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":22,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9496,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":915692,"name":"Stephanie Reyes","orcid":"0000-0002-6334-6792","position":1,"is_corresponding":false},{"id":1061416,"name":"Matthew Chase","orcid":"0000-0002-6998-2212","position":2,"is_corresponding":false},{"id":535670,"name":"Aparna Govindan","orcid":null,"position":3,"is_corresponding":false},{"id":456193,"name":"Lei Zhao","orcid":"0000-0003-4322-6475","position":4,"is_corresponding":false},{"id":315633,"name":"Jay Luther","orcid":"0000-0001-9964-7696","position":5,"is_corresponding":false},{"id":289194,"name":"Irun Bhan","orcid":"0000-0002-2163-0488","position":6,"is_corresponding":false},{"id":883454,"name":"Emily D. Bethea","orcid":"0000-0003-3759-8360","position":7,"is_corresponding":false},{"id":289192,"name":"Joseph W. Franses","orcid":"0000-0002-2517-4950","position":8,"is_corresponding":false},{"id":907240,"name":"Elizabeth Paige Walsh","orcid":"0009-0002-3540-7217","position":9,"is_corresponding":false},{"id":1062080,"name":"Leigh Anne Dageford","orcid":null,"position":10,"is_corresponding":false},{"id":407516,"name":"Shoko Kimura","orcid":"0000-0001-5250-9448","position":11,"is_corresponding":false},{"id":307944,"name":"Nahel Elias","orcid":"0000-0001-6466-7347","position":12,"is_corresponding":false},{"id":347095,"name":"Heidi Yeh","orcid":"0000-0002-7379-0600","position":13,"is_corresponding":false},{"id":1062081,"name":"James Markman","orcid":null,"position":14,"is_corresponding":false},{"id":361709,"name":"Adel Bozorgzadeh","orcid":"0000-0002-0790-9562","position":15,"is_corresponding":false},{"id":1012824,"name":"Kenneth Tanabe","orcid":null,"position":16,"is_corresponding":false},{"id":15997,"name":"Cristina R. 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