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Hepatocellular Carcinoma in the Setting of Non-cirrhotic Nonalcoholic Fatty Liver Disease and the Metabolic Syndrome: US Experience
Abstract
Background Type 2 diabetes mellitus, obesity, and the metabolic syndrome (MS) have been growing in prevalence in the USA and are independent risk factors for the development of hepatocellular carcinoma (HCC). Nonalcoholic fatty liver disease (NAFLD), the hepatic manifestation of the MS, with or without nonalcoholic steatohepatitis (NASH) can predispose to HCC in the absence of cirrhosis or advanced fibrosis. Nevertheless, the US literature investigating non-cirrhotic HCC in the setting of NAFLD/NASH and MS is lacking.Aim To describe a retrospective case series of patients who developed HCC without cirrhosis in the setting of NAFLD/NASH or features of the MS.Methods We identified NAFLD/NASH-associated HCC cases arising in the absence of cirrhosis between January 2010 and September 2012 from a tumor board database at Brooke Army Medical Center (BAMC).Results Of 44 cases of HCC reviewed, six cases of non-cirrhotic HCC associated with NAFLD/NASH and/or MS were identified. Only one patient underwent partial hepatectomy with curative intent. The other five might have been candidates for potential curative partial hepatectomy or liver transplantation had they been diagnosed earlier.Conclusion Our case series highlights the development of NAFLD/NASH and MS-associated HCC in the absence of cirrhosis in the US population and raises the important question of HCC screening for this at-risk group.
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“in another case series of 44 individuals who developed MASLD-related HCC between 2010 and 2012, only one individual without cirrhosis (out of six) underwent liver resection, while the late diagnosis impeded curative treatments in the others. 236”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [236]
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Metadata
- Authors
- Perumpail, R. B., Wong, R. J., Ahmed, A., & Harrison, S. A.
- Affiliations
- Stanford Medicine (US)
- Alameda Health System (US)
- Brooke Army Medical Center (US)
- Corresponding author
- Perumpail, Ryan B.
- Venue
- Digestive Diseases and Sciences
- Published
- 2015-08-07
- Volume
- 60
- Issue
- 10
- Pages
- 3142-3148
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- OpenAlex
- W1901124675
- Cited by
- 111
- References
- 45
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 2 · 2022: 9 · 2021: 16 · 2020: 19 · 2019: 13 · 2018: 16 · 2017: 14 · 2016: 6 · 2015: 2
- FWCI
- 7.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- hepatocellular carcinoma, non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, metabolic syndrome, non-cirrhotic liver cancer, type 2 diabetes, obesity, liver cirrhosis, partial hepatectomy, liver transplantation, HCC screening
- MeSH terms
- Aged, Female, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Male, Middle Aged, Prognosis, Retrospective Studies, United States, Cohort Studies, Comorbidity, Incidence, Survival Rate, Databases, Factual, Age Distribution, Sex Distribution, Risk Assessment, Metabolic Syndrome, Non-alcoholic Fatty Liver Disease
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