Hepatocellular carcinoma in Japanese patients with nonalcoholic fatty liver disease, alcoholic liver disease, and chronic liver disease of unknown etiology: report of the nationwide survey
Abstract
Purpose To clarify the etiology of hepatocellular carcinoma (HCC) in Japanese patients with non-viral liver disease, we performed a nationwide survey. The influence of obesity, lifestyle-related diseases, and alcohol consumption was focused on.Methods A nationwide survey of 14,530 HCC patients was conducted in 2009. Clinical features were studied for HCC patients with nonalcoholic fatty liver disease (NAFLD-HCC; n = 292), alcoholic liver disease (ALC-HCC; n = 991), and chronic liver disease of unknown etiology (unknown HCC; n = 614). The unknown HCC was divided into two subgroups, a no alcohol intake group and a modest alcohol intake group.Results ALC-HCC accounted for 7.2% of all HCC, followed by unknown HCC (5.1%) and NAFLD-HCC (2.0%). The characteristics of these three groups were clearly different (median age was 72 years for NAFLD-HCC, 68 years for ALC-HCC, and 73 years for unknown HCC, p < 0.01; female gender was 38, 4, and 37%, respectively, p < 0.01). Obesity and lifestyle-related diseases were significantly more frequent in NAFLD-HCC than in ALC-HCC and unknown HCC. The no alcohol intake subgroup of unknown HCC showed female predominance (58%) and was older, without a high prevalence of obesity and lifestyle-related diseases. In contrast, the modest alcohol intake subgroup showed the same trends regarding gender, body mass index, prevalence of lifestyle-related diseases, and liver function as the ALC-HCC group.Conclusions The clinical features of ALC-HCC, NAFLD-HCC, and unknown HCC were clearly different. Modest intake of alcohol might have a more significant role in hepatic carcinogenesis than is presently thought.
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Similar observations have been confirmed in a European study and two Japanese studies, where cirrhosis was absent in 38% and 49% of individuals with MASLD-related HCC, respectively.
“Similar observations have been con fi rmed in a European study 232 and two Japanese studies, where cirrhosis was absent in 38% and 49% of individuals with MASLD-related HCC, respectively. 233,234”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [233]
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“However, no significant difference in overall 5-year survival is found among HCC patients with or without NAFLD-related etiologies (Tokushige et al., 2011).”
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- Authors
- Tokushige, K., Hashimoto, E., Horie, Y., Taniai, M., & Higuchi, S.
- Affiliations
- Tokyo Women's Medical University (JP)
- Sanno Hospital (JP)
- National Hospital Organization (JP)
- Corresponding author
- Hashimoto, Etsuko
- Venue
- Journal of Gastroenterology
- Published
- 2011-07-13
- Volume
- 46
- Issue
- 10
- Pages
- 1230-1237
- ISSN
- 0944-1174 (ISSN-L)
- 1435-5922
- OpenAlex
- W2092313557
- Cited by
- 124
- References
- 31
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 16 · 2019: 7 · 2018: 5 · 2017: 14 · 2016: 12 · 2015: 12 · 2014: 13 · 2013: 11 · 2012: 3
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- hepatocellular carcinoma, non-alcoholic fatty liver disease, alcoholic liver disease, HCC etiology, obesity, lifestyle-related diseases, alcohol consumption, hepatocarcinogenesis, Japanese patients, clinical features
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Chronic Disease, Fatty Liver, Female, Health Surveys, Carcinoma, Hepatocellular, Humans, Japan, Life Style, Liver Diseases, Liver Diseases, Alcoholic, Liver Neoplasms, Male, Middle Aged, Obesity, Sex Factors, Prevalence, Non-alcoholic Fatty Liver Disease
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