Metabolic‐associated fatty liver disease and hepatocellular carcinoma: a prospective study of characteristics and response to therapy

Background and Aim The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic‐associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of...

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Published in:	Journal of gastroenterology and hepatology Vol. 39; no. 6; pp. 1048 - 1056
Main Authors:	Batt, NM, Rodrigues, B, Bloom, S, Sawhney, R, George, ES, Hodge, A, Vootukuru, N, McCrae, C, Sood, Surbhi, Roberts, SK, Dev, A, Bell, S, Thompson, A, Ryan, MC, Kemp, W, Gow, PJ, Sood, Siddharth, Nicoll, AJ
Format:	Journal Article
Language:	English
Published:	Australia Wiley Subscription Services, Inc 01-06-2024
Subjects:	Aged Australia - epidemiology Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - etiology Carcinoma, Hepatocellular - therapy Cirrhosis Cohort Studies Dyslipidemia Fatty liver Fatty Liver - diagnosis Fatty Liver - epidemiology Fatty Liver - etiology Fatty Liver - therapy Female HCC Hepatocellular carcinoma Humans Life Style Lifestyle Liver cancer Liver diseases Liver Neoplasms - epidemiology Liver Neoplasms - etiology Liver Neoplasms - therapy MAFLD Male Metabolic syndrome Metabolic Syndrome - epidemiology Metabolism Middle Aged Non-alcoholic Fatty Liver Disease - epidemiology Non-alcoholic Fatty Liver Disease - therapy Prospective Studies Statins Treatment Outcome Australia Liver cancer MAFLD HCC Lifestyle Metabolic syndrome
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Summary:	Background and Aim The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic‐associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of HCC patients in an Australian population. Method Multicenter prospective cohort analysis of newly diagnosed HCC patients at six multidisciplinary team meetings over a 2‐year period. Results Three hundred and thirteen (313) newly diagnosed HCC patients with MAFLD (n = 77), MAFLD plus other liver disease (n = 57) (the “mixed” group), and non‐MAFLD (n = 179) were included in the study. Alcohol‐associated liver disease (ALD) (43%) and MAFLD (43%) were the most common underlying liver diseases. MAFLD‐HCC patients were older (73 years vs 67 years vs 63 years), more likely to be female (40% vs 14% vs 20%), less likely to have cirrhosis (69% vs 88% vs 85%), showed higher ECOG, and were less likely to be identified by screening (29% vs 53% vs 45%). Metabolic syndrome was more prevalent in the MAFLD and mixed groups. The severity of underlying liver disease and HCC characteristics were the same across groups. While the MAFLD population self‐reported more sedentary lifestyles, reported dietary patterns were no different across the groups. Dyslipidemia was associated with tumor size, and those taking statins had a lower recurrence rate. Conclusion Equal to ALD, MAFLD is now the most common underlying liver disease seen in HCC patients in Australia. Future HCC prevention screening and treatment strategies need to take this important group of patients into consideration.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0815-9319 1440-1746 1440-1746
DOI:	10.1111/jgh.16501