Diabetes and Risk of Hepatocellular Carcinoma in Cirrhosis Patients with Nonalcoholic Fatty Liver Disease

Teng, Pai‐Chi; Huang, Daniel Q.; Lin, Ting‐Yi; Noureddin, Mazen; Yang, Ju Dong

doi:10.5009/gnl220357

Cited by 11 publications

(4 citation statements)

References 93 publications

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“…Further research should consider incorporating additional factors such as sex, cancer stage, cancer size, CTP score, performance status, comorbidities, surgical method, and hospital size into the scoring system. 76 , 77 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Lee,

Park,

Ryoo

et al. 2024

Gut and Liver

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Background/Aims: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. Methods:The studies included in this meta-analysis were selected from Ovid-MEDLINE, Ovid-Embase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol. Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications.Results: Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and diseasefree survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postoperative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). Conclusions:The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Lee,

Park,

Ryoo

et al. 2024

Gut and Liver

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“…Diabetes is a common chronic disease. Many previous studies have investigated the risk of cancer in patients with diabetes and shown that diabetes increases the risk of many kinds of cancer, including liver cancer ( 26 ), pancreatic cancer ( 27 ), endometrial cancer ( 28 ), breast cancer ( 29 ), colon cancer ( 30 ), kidney cancer ( 31 ), and bladder cancer ( 32 ). Diabetes is closely related to frailty.…”

Section: Discussionmentioning

confidence: 99%

The Frailty Index and colon cancer: a 2-sample Mendelian-randomization study

Gao¹,

Di²,

Gao³

et al. 2023

J Gastrointest Oncol

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Background Frailty is closely related to cancer. Previous research has shown that cancer patients are prone to frailty, and frailty increases the risk of adverse outcomes in cancer patients. However, it is unclear whether frailty increases the risk of cancer. This 2-sample Mendelian-randomization (MR) study sought to analyze the relationship between frailty and the risk of colon cancer. Methods The database was extracted from the Medical Research Council Integrative Epidemiology Unit (MRC-IEU) in 2021. The genome-wide association study (GWAS) data related to colon cancer was obtained from the GWAS website ( http://gwas.mrcieu.ac.uk/datasets ), involving 462,933 individuals’ gene information. Single-nucleotide polymorphisms (SNPs) were defined as the instrumental variables (IVs). The SNPs closely associated with the Frailty Index at a genome-wide significance level were selected. To further screen the IVs, we selected the confounding factors using the PhenoScanner ( http://www.phenoscanner.medschl.cam.ac.uk/phenoscanner ). To estimate the causal effect of the Frailty Index on colon cancer, the MR-Egger regression, weighted median (WM1), inverse-variance weighted (IVW), and weight mode (WM2) methods were applied to calculate the SNP-frailty index and the SNP-cancer estimates. Cochran’s Q statistic was used to estimate heterogeneity. The two-sample Mendelian randomization (TSMR) analysis was performed using the “TwoSampleMR” and “plyr” packages. All the statistical tests were 2-tailed, and a P value <0.05 was considered statistically significant. Results We selected 8 SNPs as the IVs. The results of the IVW analysis [odds ratio (OR) =0.995, 95% confidence interval (CI): 0.990–1.001, P=0.052] showed that the genetic changes in the Frailty Index were not statistically associated with the risk of colon cancer, and no significant heterogeneity between these 8 genes was observed (Q =7.382, P=0.184). The MR-Egger (OR =0.987, 95% CI: 0.945–1.031, P=0.581), WM1 (OR =0.995, 95% CI: 0.990–1.001, P=0.118), WM2 (OR =0.996, 95% CI: 0.988–1.004, P=0.356), and SM (OR =0.996, 95% CI: 0.987–1.005, P=0.449) results were also consistent with each other. The sensitivity analysis based on the leave-one-out method showed that the individual SNPs did not affect the robustness of the results. Conclusions Frailty might have no effect on the risk of colon cancer.

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“…Type two diabetes mellitus (T2DM) is a prevalent and firmly-established risk factor for NAFLD and is associated with an increased risk of liver disease progression [ 74 , 75 , 76 ]. Several studies have demonstrated that T2DM is associated with an elevated risk of NAFLD-related HCC [ 54 ].…”

Section: Risk Factors Associated With Nafld-related Hepatocellular Ca...mentioning

confidence: 99%

Exploring Opportunities to Enhance the Screening and Surveillance of Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease (NAFLD) through Risk Stratification Algorithms Incorporating Ultrasound Elastography

Lupșor-Platon

2023

Cancers

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Non-alcoholic fatty liver disease (NAFLD), with its progressive form, non-alcoholic steatohepatitis (NASH), has emerged as a significant public health concern, affecting over 30% of the global population. Hepatocellular carcinoma (HCC), a complication associated with both cirrhotic and non-cirrhotic NAFLD, has shown a significant increase in incidence. A substantial proportion of NAFLD-related HCC occurs in non-cirrhotic livers, highlighting the need for improved risk stratification and surveillance strategies. This comprehensive review explores the potential role of liver ultrasound elastography as a risk assessment tool for HCC development in NAFLD and highlights the importance of effective screening tools for early, cost-effective detection and improved management of NAFLD-related HCC. The integration of non-invasive tools and algorithms into risk stratification strategies could have the capacity to enhance NAFLD-related HCC screening and surveillance effectiveness. Alongside exploring the potential advancement of non-invasive tools and algorithms for effectively stratifying HCC risk in NAFLD, we offer essential perspectives that could enable readers to improve the personalized assessment of NAFLD-related HCC risk through a more methodical screening approach.

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Diabetes and Risk of Hepatocellular Carcinoma in Cirrhosis Patients with Nonalcoholic Fatty Liver Disease

Cited by 11 publications

References 93 publications

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

The Frailty Index and colon cancer: a 2-sample Mendelian-randomization study

Exploring Opportunities to Enhance the Screening and Surveillance of Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease (NAFLD) through Risk Stratification Algorithms Incorporating Ultrasound Elastography

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