NAFLD–related HCC: Lower surveillance rates and cirrhosis prevalence

Patients with non-alcoholic fatty liver disease (NAFLD) are at a higher risk of developing liver-related complications. This includes liver decompensation and hepatocellular carcinoma (HCC). Although this association is well-known, no comprehensive meta-analysis comparing the clinical presentation and outcomes of NAFLD-related HCC to that of non-NAFLD-related HCC currently exists.
PUBLISHED IN: Lancet Oncology (March 2022)

Comment:

Patients with non-alcoholic fatty liver disease (NAFLD) are at a higher risk of developing liver-related complications. This includes liver decompensation and hepatocellular carcinoma (HCC).
Although this association is well-known, no comprehensive meta-analysis comparing the clinical presentation and outcomes of NAFLD-related HCC to that of non-NAFLD-related HCC currently exists.

The aim of this review was to provide a comprehensive global overview of the prevalence, presentation, surveillance rates, treatment allocations, and outcomes of NAFLD-related HCC compared to HCC due to other causes.

Patients with non-alcoholic fatty liver disease (NAFLD) are at a higher risk of developing liver-related complications. This includes liver decompensation and hepatocellular carcinoma (HCC).
Although this association is well-known, no comprehensive meta-analysis comparing the clinical presentation and outcomes of NAFLD-related HCC to that of non-NAFLD-related HCC currently exists.

The aim of this review was to provide a comprehensive global overview of the prevalence, presentation, surveillance rates, treatment allocations, and outcomes of NAFLD-related HCC compared to HCC due to other causes.

Key learnings:

The global proportion of HCC secondary to NAFLD is rising.
Furthermore, while patients with NAFLD-related HCC were older, had a high BMI, and more metabolic comorbidities, almost 40% of patients with NAFLD-related HCC did not have cirrhosis, compared to 15% of patients with non-NAFLD-related HCC. Importantly, a significantly lower proportion of patients with NAFLD-related HCC underwent surveillance before HCC diagnosis.
The absence of cirrhosis in patients with NAFLD-related HCC is a significant finding as it led to a lack of routine HCC surveillance before diagnosis, as per current practice guidelines. As the proportion of patients with NAFLD-related HCC continues to grow, strategies to improve surveillance and address the metabolic risk factors associated with NAFLD-related HCC must thus be urgently developed.

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Dr. S Duarte

Dr. S Duarte

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