Hepatectomy for Metabolic Associated Fatty Liver Disease (MAFLD) related HCC: Propensity case-matched analysis with viral- and alcohol-related HCC

Francesco Ardito, Felice Giuliante, Simone Conci, Federica Cipriani, Matteo Donadon, Ivan Marchitelli, Simone Famularo, Pasquale Perri, Maurizio Iaria, Luca Ansaloni, Matteo Zanello, Giuliano La Barba, Stefan Patauner, Enrico Pinotti, Sarah Molfino, Paola Germani, Maurizio Romano, Ivano Sciannamea, Cecilia Ferrari, Alberto ManzoniAlbert Troci, Luca Fumagalli, Antonella Delvecchio, Antonio Floridi, Riccardo Memeo, Marco Chiarelli, Michele Crespi, Giuseppe Zimmitti, Guido Griseri, Adelmo Antonucci, Giacomo Zanus, Paola Tarchi, Gian Luca Baiocchi, Mauro Zago, Antonio Frena, Giorgio Ercolani, Elio Jovine, Marcello Maestri, Raffaele Dalla Valle, Gian Luca Grazi, Fabrizio Romano, Guido Torzilli, Luca Aldrighetti, Andrea Ruzzenente

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background and aims: We investigated the clinical impact of the newly defined metabolic-associated fatty liver disease (MAFLD) in patients undergoing hepatectomy for HCC (MAFLD-HCC) comparing the characteristics and outcomes of patients with MAFLD-HCC to viral- and alcoholic-related HCC (HCV-HCC, HBV-HCC, A-HCC). Methods: A retrospective analysis of patients included in the He.RC.O.Le.S. Group registry was performed. The characteristics, short- and long-term outcomes of 1315 patients included were compared according to the study group before and after an exact propensity score match (PSM). Results: Among the whole study population, 264 (20.1%) had MAFLD-HCC, 205 (15.6%) had HBV-HCC, 671 (51.0%) had HCV-HCC and 175 (13.3%) had A-HCC. MAFLD-HCC patients had higher BMI (p < 0.001), Charlson Comorbidities Index (p < 0.001), size of tumour (p < 0.001), and presence of cirrhosis (p < 0.001). After PSM, the 90-day mortality and severe morbidity rates were 5.9% and 7.1% in MAFLD-HCC, 2.3% and 7.1% in HBV-HCC, 3.5% and 11.7% in HCV-HCC, and 1.2% and 8.2% in A-HCC (p = 0.061 and p = 0.447, respectively). The 5-year OS and RFS rates were 54.4% and 37.1% in MAFLD-HCC, 64.9% and 32.2% in HBV-HCC, 53.4% and 24.7% in HCV-HCC and 62.0% and 37.8% in A-HCC (p = 0.345 and p = 0.389, respectively). Cirrhosis, multiple tumours, size and satellitosis seems to be the independent predictors of OS. Conclusion: Hepatectomy for MAFLD-HCC seems to have a higher but acceptable operative risk. However, long-term outcomes seems to be related to clinical and pathological factors rather than aetiological risk factors.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
Numero di pagine10
RivistaEuropean Journal of Surgical Oncology
Volume2021
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Hepatectomy
  • Hepatocellular carcinoma
  • NAFLD
  • Metabolic associated fatty liver disease
  • Metabolic syndrome
  • Liver resection

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