Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis: HCC and Steatosis or Steatohepatitis.
Hepatocellular carcinoma
Meta-analysis
NASH
Nonalcoholic fatty liver disease
Steatosis
Journal
Neoplasia (New York, N.Y.)
ISSN: 1476-5586
Titre abrégé: Neoplasia
Pays: United States
ID NLM: 100886622
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
19
01
2022
accepted:
16
05
2022
pubmed:
1
6
2022
medline:
9
6
2022
entrez:
31
5
2022
Statut:
ppublish
Résumé
Hepatic steatosis of nonalcoholic etiology (nonalcoholic fatty liver disease; NAFLD) is an emergent condition that may lead to hepatic cirrhosis and finally to liver cancer. We evaluate the risk of developing hepatocellular carcinoma (HCC) and quantify the prognosis in terms of recurrence (DFS) as well as HCC-specific and overall survival (CSS and OS) of patients with and without NAFLD. We searched published articles that evaluated the risk and outcomes of HCC in patients with steatosis/steatohepatitis from inception to July 2021 were identified by searching the PubMed, EMBASE, and Cochrane Library databases. Prospective cohort, case-control, or retrospective studies were selected that were published in English and provided incidence and survival rates of HCC patients with NAFLD. A random-effects model was created to estimate the pooled effect size. The primary outcome of interest was HCC incidence. The secondary endpoints were DFS, CSS, and OS. In total, 948 217 patients with NAFLD were analyzed, from n = 103 observational studies. NAFLD significantly increased the risk of HCC (HR = 1.88 [95% CI, 1.46-2.42]; P < .01] but not risk of recurrence (HR = 0.99 [95% CI, 0.85-1.15]; P = .9) or overall mortality (HR = 1.04 [95% CI, 0.88-1.24]; P = 0.64). Conversely, NAFLD increased HCC-related mortality risk (HR = 2.16 [95% CI, 0.85-5.5]; P = .1). Risk of HCC was increased in Western countries but not in Asian countries. Patients with NAFLD have an increased risk of HCC as compared to patients without NAFLD. NAFLD also increases liver cancer (HCC) mortality. These results justify applying general measures to patients with proven NAFLD and monitoring patients with NASH and fibrosis.
Sections du résumé
BACKGROUND AND AIMS
Hepatic steatosis of nonalcoholic etiology (nonalcoholic fatty liver disease; NAFLD) is an emergent condition that may lead to hepatic cirrhosis and finally to liver cancer. We evaluate the risk of developing hepatocellular carcinoma (HCC) and quantify the prognosis in terms of recurrence (DFS) as well as HCC-specific and overall survival (CSS and OS) of patients with and without NAFLD.
METHODS
We searched published articles that evaluated the risk and outcomes of HCC in patients with steatosis/steatohepatitis from inception to July 2021 were identified by searching the PubMed, EMBASE, and Cochrane Library databases. Prospective cohort, case-control, or retrospective studies were selected that were published in English and provided incidence and survival rates of HCC patients with NAFLD. A random-effects model was created to estimate the pooled effect size. The primary outcome of interest was HCC incidence. The secondary endpoints were DFS, CSS, and OS.
RESULTS
In total, 948 217 patients with NAFLD were analyzed, from n = 103 observational studies. NAFLD significantly increased the risk of HCC (HR = 1.88 [95% CI, 1.46-2.42]; P < .01] but not risk of recurrence (HR = 0.99 [95% CI, 0.85-1.15]; P = .9) or overall mortality (HR = 1.04 [95% CI, 0.88-1.24]; P = 0.64). Conversely, NAFLD increased HCC-related mortality risk (HR = 2.16 [95% CI, 0.85-5.5]; P = .1). Risk of HCC was increased in Western countries but not in Asian countries.
CONCLUSIONS
Patients with NAFLD have an increased risk of HCC as compared to patients without NAFLD. NAFLD also increases liver cancer (HCC) mortality. These results justify applying general measures to patients with proven NAFLD and monitoring patients with NASH and fibrosis.
Identifiants
pubmed: 35636146
pii: S1476-5586(22)00036-7
doi: 10.1016/j.neo.2022.100809
pmc: PMC9157194
pii:
doi:
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
100809Informations de copyright
Copyright © 2022. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None to declare
Références
Hepatology. 2015 May;61(5):1547-54
pubmed: 25125077
Clin Gastroenterol Hepatol. 2019 Mar;17(4):748-755.e3
pubmed: 29908364
Clin Gastroenterol Hepatol. 2022 Feb;20(2):283-292.e10
pubmed: 33965578
Hepatology. 2016 Jul;64(1):73-84
pubmed: 26707365
JAMA. 2020 Mar 24;323(12):1175-1183
pubmed: 32207804
J Hepatol. 2014 Jul;61(1):75-81
pubmed: 24607626
PLoS One. 2021 Jan 25;16(1):e0245921
pubmed: 33493235
Hepatology. 2018 Jan;67(1):328-357
pubmed: 28714183
Clin Gastroenterol Hepatol. 2016 Jan;14(1):124-31.e1
pubmed: 26196445
Eur J Gastroenterol Hepatol. 2021 Jan;33(1):62-68
pubmed: 32091438
Nature. 2021 Apr;592(7854):450-456
pubmed: 33762733
Cancer Control. 2017 Jul-Sep;24(3):1073274817729245
pubmed: 28975830
Aliment Pharmacol Ther. 2018 Oct;48(7):696-703
pubmed: 30136293
Hepatology. 2012 Oct;56(4):1580-4
pubmed: 23038652
PLoS One. 2017 Mar 27;12(3):e0173499
pubmed: 28346543
Hepatology. 2019 Jan;69(1):107-120
pubmed: 29665135
Hepatology. 2019 Oct;70(4):1119-1133
pubmed: 31070259