Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Xue, Jiao; Wang, Qingxia; Xiao, Hang; Shi, Meijie; Xie, Yubao; Li, Sheng; Lin, Ming De; Chi, Xiaoling

doi:10.2147/cmar.s368366

Cited by 9 publications

(6 citation statements)

References 21 publications

(24 reference statements)

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“…Some studies also illustrated that MAFLD might be a risk factor. For HBV-related HCC patients, Xue et al concluded that MAFLD was associated with a higher risk of poor prognosis [24]. Patients with CHB and coexisting MAFLD had a higher likelihood of experiencing liver-related clinical events and mortality [25].…”

Section: Discussionmentioning

confidence: 99%

Is metabolic dysfunction-associated fatty liver disease a protective factor in hepatocellular carcinoma patients after hepatectomy? A retrospective study based on different analysis methods

Kong,

Gao,

et al. 2023

Preprint

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Background Metabolic dysfunction-associated fatty liver disease (MAFLD) has been recognized as an accurate reflection of the pathogenesis of fatty liver disease by a consensus document. However, the relationship between MAFLD and the prognosis of patients with hepatocellular carcinoma (HCC) remains unclear. Therefore, the main purpose of this study was to investigate the impact of MAFLD on the prognosis of HCC patients after hepatectomy. Methods To identify risk factors associated with poor prognosis, we used a multivariate Cox proportional hazards model. We also conducted propensity score matching (PSM) analysis to balance the baseline characteristics between the MAFLD and non-MAFLD groups. Kaplan‒Meier survival curves were used to compare the prognosis of the two matched groups. Results This study involved 909 HCC patients who underwent hepatectomy between January 2011 and December 2017 at the West China Hospital of Sichuan University, including 97 patients with MAFLD (MAFLD group) and 812 patients without MAFLD (non-MAFLD group). Our multivariate analysis results indicated that MAFLD might be a protective factor for overall survival (OS) (p = 0.032), but not for recurrence-free survival (RFS) (p = 0.214). After conducting PSM analysis, we found that the RFS rates in the MAFLD group were higher at the 1-, 3-, and 5-year intervals, with rates of 72.7%, 59.0%, and 49.9%, respectively, than those in the non-MAFLD group, which had rates of 69.8%, 54.3%, and 43.2%, respectively. Therefore, MAFLD might improve the 1-year, 3-year, and 5-year RFS rates of HCC patients who undergo hepatectomy. In the subgroup analysis, we found that patients in the overweight group had better RFS than those in the lean/normal group (p＜0.001). Conclusions In summary, our study suggests that MAFLD might be a protective factor for the OS of HCC patients who underwent hepatectomy through multivariate analysis. Furthermore, after PSM analysis, MAFLD was found to improve the 1-year, 3-year, and 5-year RFS rates of HCC patients who underwent hepatectomy, especially those who were overweight. These findings may have implications for the management and treatment of HCC patients with MAFLD.

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Section: Discussionmentioning

confidence: 99%

Is metabolic dysfunction-associated fatty liver disease a protective factor in hepatocellular carcinoma patients after hepatectomy? A retrospective study based on different analysis methods

Kong,

Gao,

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Substantive literature has shown that individuals who have underlying liver diseases from hepatitis B and hepatitis C, with a diagnosis of MAFLD, have significantly increased complications, both intra- and extra-hepatic [ 13 ]. The additional diagnosis of MAFLD coupled with hepatitis B, for example, increases the rates of complications and mortality [ 57 ].…”

Section: Mafld Clinical Differencesmentioning

confidence: 99%

MAFLD: How is it different from NAFLD?

et al. 2023

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Metabolic (dysfunction) associated fatty liver disease (MAFLD) is the term suggested in 2020 to refer to fatty liver disease related to systemic metabolic dysregulation. The name change to MAFLD comes with a simple set of criteria to enable easy diagnosis at the bedside for the general medical community, including for primary care physicians. Since the introduction of the term, there have been key areas in which the superiority of MAFLD over the traditional NAFLD terminology has been demonstrated including for the risk of liver and extrahepatic mortality, disease associations, and for identifying high risk individuals. Additionally, MAFLD has been adopted by a number of leading pannational and national societies due to its concise diagnostic criterion, removal of the requirement to exclude concomitant liver diseases, and reduction in stigma associated with this condition. This article explores the differences between MAFLD and NAFLD diagnosis, areas of benefit, some potential limitations, and how the MAFLD terminology has opened up new fields of research.

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“…Regarding HCC risk specifically, simultaneous HBV and MAFLD appears to be common amongst HBV patients with HCC ( Table 1 ) . One large Taiwanese study reporting that amongst a cohort of 800 patients diagnosed with early-stage HBV HCC between 2009 and 2018, 45.6% had concurrent MAFLD [ 59 ], while MAFLD prevalence in a Chinese cohort of 453 patients with HBV-related HCC was 57% [ 60 ]. A large Korean insurance registry study in HBsAg-positive individuals reported that the co-presence of MAFLD significantly increased the risk of HCC development with an adjusted hazard ratio of 1.37 [ 61 ].…”

Section: Combined Aetiology Hccmentioning

confidence: 99%

“…Similarly, a Chinese study found metabolic syndrome to be independently associated with a twofold increased HCC risk amongst 6,545 prospectively enrolled individuals with HBV after adjusting for age, gender, cigarette smoking, alcohol consumption, liver cirrhosis, and elevated aspartate aminotransferase levels [ 62 ]. Some studies have reported poorer prognosis in patients with concurrent HBV MAFLD HCC, including increased HCC recurrence and all-cause mortality following surgical resection, as well as higher risk of death and progression [ 60 , 63 ].…”

Section: Combined Aetiology Hccmentioning

confidence: 99%

MAFLD: an optimal framework for understanding liver cancer phenotypes

et al. 2023

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Hepatocellular carcinoma has a substantial global mortality burden which is rising despite advancements in tackling the traditional viral risk factors. Metabolic (dysfunction) associated fatty liver disease (MAFLD) is the most prevalent liver disease, increasing in parallel with the epidemics of obesity, diabetes and systemic metabolic dysregulation. MAFLD is a major factor behind this sustained rise in HCC incidence, both as a single disease entity and often via synergistic interactions with other liver diseases. Mechanisms behind MAFLD-related HCC are complex but is crucially underpinned by systemic metabolic dysregulation with variable contributions from interacting disease modifiers related to environment, genetics, dysbiosis and immune dysregulation. MAFLD-related HCC has a distinct clinical presentation, most notably its common occurrence in non-cirrhotic liver disease. This is just one of several major challenges to effective surveillance programmes. The response of MAFLD-related HCC to immune-checkpoint therapy is currently controversial, and is further complicated by the high prevalence of MAFLD in individuals with HCC from viral aetiologies. In this review, we highlight the current data on epidemiology, clinical characteristics, outcomes and screening controversies. In addition, concepts that have arisen because of the MAFLD paradigm such as HCC in MAFLD/NAFLD non-overlapping groups, dual aetiology tumours and MAFLD sub-phenotypes is reviewed.

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Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Cited by 9 publications

References 21 publications

Is metabolic dysfunction-associated fatty liver disease a protective factor in hepatocellular carcinoma patients after hepatectomy? A retrospective study based on different analysis methods

Is metabolic dysfunction-associated fatty liver disease a protective factor in hepatocellular carcinoma patients after hepatectomy? A retrospective study based on different analysis methods

MAFLD: How is it different from NAFLD?

MAFLD: an optimal framework for understanding liver cancer phenotypes

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