Clinical heterogeneity in patients with non-alcoholic fatty liver disease-associated hepatocellular carcinoma

Anastasopoulos, Nikolaos-Andreas; Lianos, Georgios D; Tatsi, V.; Karampa, Anastasia; Goussia, Anna; Glantzounis, Georgios K.

doi:10.1080/17474124.2020.1802244

Cited by 12 publications

(11 citation statements)

References 93 publications

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“…Viral hepatitis-related HCC usually occurs in the background of the advanced stage of cirrhosis. Though classically HCC usually occurs in the advanced stage of cirrhosis in the NAFLD spectrum, this is not true for all the cases of NAFLD-related HCC[ 116 ]. Rather one of the most common causes of chronic liver disease-related HCC without evidence of cirrhosis is NAFLD[ 5 ].…”

Section: Clinical Implications Of Nafld Heterogeneitymentioning

confidence: 99%

Heterogeneity of non-alcoholic fatty liver disease: Implications for clinical practice and research activity

Pal¹,

Palui²,

Ray³

2021

WJH

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Non-alcoholic fatty liver disease (NAFLD) is a heterogeneous condition with a wide spectrum of clinical presentations and natural history and disease severity. There is also substantial inter-individual variation and variable response to a different therapy. This heterogeneity of NAFLD is in turn influenced by various factors primarily demographic/dietary factors, metabolic status, gut microbiome, genetic predisposition together with epigenetic factors. The differential impact of these factors over a variable period of time influences the clinical phenotype and natural history. Failure to address heterogeneity partly explains the sub-optimal response to current and emerging therapies for fatty liver disease. Consequently, leading experts across the globe have recently suggested a change in nomenclature of NAFLD to metabolic-associated fatty liver disease (MAFLD) which can better reflect current knowledge of heterogeneity and does not exclude concomitant factors for fatty liver disease ( e.g. alcohol, viral hepatitis, etc. ). Precise identification of disease phenotypes is likely to facilitate clinical trial recruitment and expedite translational research for the development of novel and effective therapies for NAFLD/MAFLD.

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Section: Clinical Implications Of Nafld Heterogeneitymentioning

confidence: 99%

Heterogeneity of non-alcoholic fatty liver disease: Implications for clinical practice and research activity

Pal¹,

Palui²,

Ray³

2021

WJH

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“…The main reason for this is the increase in obesity and metabolic syndrome, closely related to NAFLD and NASH. NAFLD and NASH are expected to become the first cause of liver cirrhosis and hepatocellular carcinoma in the following decades [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Individualized Approach in the Surgical Management of Hepatocellular Carcinoma: Results from a Greek Multicentre Study

Glantzounis

Korkolis

Sotiropoulos

et al. 2022

Cancers

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Background: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of death worldwide. The management of HCC is complex, with surgical treatment providing long-term survival in eligible patients. This study aims to present the experience of aggressive surgical management of HCC in Greece. Methods: This is a retrospective multicentre clinical study with 242 patients. Results: Most patients were male (79%) and had a median age of 71 yrs. According to the most recent BCLC criteria, 172 patients (71.1%) were classified as BCLC 0-A stage, 33 patients (13.6%) were classified as BCLC B, and 37 (15.3%) were classified as BCLC C. A total of 54% of the patients underwent major hepatectomy. Major postoperative morbidity was 15.6%, and the 90-day postoperative mortality rate was 4.5%. The median follow-up was 33.5 months. Three- and five-year overall survival was 65% and 48%, respectively. The median overall survival was 55 months. Significantly, five-year survival was 55% for BCLC A, and 34% and 21% for BCLC B and C, respectively. In univariate analysis, cirrhosis, type of resection (R status), and BCLC stage were associated with overall survival. Multivariate analysis indicated that R1 and R2 resections compared to R0, and BCLC C compared to BCLC 0-A, were independently associated with increased mortality. Conclusions: Aggressive surgical treatment of HCC offers satisfactory long-term survival prospects. A significant percentage (29%) of HCCs that underwent liver resection were of the intermediate and advanced BCLC stage. The management of patients with HCC should be discussed in multidisciplinary tumour board meetings on a case-by-case basis to be more effective.

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“…A population-based cohort (n = 8,892) study indicated that NAFLD patients had significantly increased overall cancer incidence, especially HCC, compared to the controls, adding evidence of cancer risk in patients with NAFLD [28]. The characteristics of patients with HCC, secondary to NAFLD, are older age, large tumors due to late diagnosis, often without cirrhosis, and high prevalence of the metabolic syndrome components, leading to an increased mortality rate [2].…”

Section: Introductionmentioning

confidence: 99%

Screening for aberrantly methylated and differentially expressed genes in nonalcoholic fatty liver disease of hepatocellular carcinoma patients with cirrhosis

Zhang

Hou

2022

World J Surg Onc

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Background Nonalcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide causes hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to find potential aberrantly methylated and differentially expressed genes in NAFLD of HCC patients with cirrhosis. Methods DNA methylation data, mRNA expression data, and the corresponding clinical information of HCC were downloaded from the Cancer Genome Atlas (TCGA, tissue sample) database. HCC patients with cirrhosis were divided into two groups according to the presence of NAFLD. The differentially expressed genes (DEGs) and differentially methylated genes (DMGs) were obtained. Results By overlapping 79 up-regulated genes and 1020 hypomethylated genes, we obtained 5 hypomethylated-highly expressed genes (HypoHGs). By overlapping 365 down-regulated genes and 481 hypermethylated genes, we identified 13 hypermethylated-lowly expressed genes (Hyper-LGs). Survival analysis of these 18 MDEGs indicated that the expression of DGKK and HOXD9 was significantly correlated with the overall survival time of NAFLD patients. Conclusions We identified several candidate genes whose expressions were regulated by DNA methylation of NAFLD of HCC with cirrhosis, which may provide a new field in understanding the clinical pathological mechanism of NAFLD of HCC with cirrhosis.

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Clinical heterogeneity in patients with non-alcoholic fatty liver disease-associated hepatocellular carcinoma

Cited by 12 publications

References 93 publications

Heterogeneity of non-alcoholic fatty liver disease: Implications for clinical practice and research activity

Heterogeneity of non-alcoholic fatty liver disease: Implications for clinical practice and research activity

Individualized Approach in the Surgical Management of Hepatocellular Carcinoma: Results from a Greek Multicentre Study

Screening for aberrantly methylated and differentially expressed genes in nonalcoholic fatty liver disease of hepatocellular carcinoma patients with cirrhosis

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