TY - JOUR
T1 - Hepatectomy for Metabolic Associated Fatty Liver Disease (MAFLD) related HCC
T2 - Propensity case-matched analysis with viral- and alcohol-related HCC
AU - HE.RC.O.LE.S. Group
AU - Conci, Simone
AU - Cipriani, Federica
AU - Donadon, Matteo
AU - Marchitelli, Ivan
AU - Ardito, Francesco
AU - Famularo, Simone
AU - Perri, Pasquale
AU - Iaria, Maurizio
AU - Ansaloni, Luca
AU - Zanello, Matteo
AU - La Barba, Giuliano
AU - Patauner, Stefan
AU - Pinotti, Enrico
AU - Molfino, Sarah
AU - Germani, Paola
AU - Romano, Maurizio
AU - Sciannamea, Ivano
AU - Ferrari, Cecilia
AU - Manzoni, Alberto
AU - Troci, Albert
AU - Fumagalli, Luca
AU - Delvecchio, Antonella
AU - Floridi, Antonio
AU - Memeo, Riccardo
AU - Chiarelli, Marco
AU - Crespi, Michele
AU - Zimmitti, Giuseppe
AU - Griseri, Guido
AU - Antonucci, Adelmo
AU - Zanus, Giacomo
AU - Tarchi, Paola
AU - Baiocchi, Gian Luca
AU - Zago, Mauro
AU - Frena, Antonio
AU - Ercolani, Giorgio
AU - Jovine, Elio
AU - Maestri, Marcello
AU - Valle, Raffaele Dalla
AU - Grazi, Gian Luca
AU - Romano, Fabrizio
AU - Giuliante, Felice
AU - Torzilli, Guido
AU - Aldrighetti, Luca
AU - Ruzzenente, Andrea
N1 - Funding Information:
Giovanni Lazzari [1], Francesca Ratti [2], Guido Costa [4], Manuela Bellobono [5], Mattia Garancini [6], Cristina Ciulli [6],Valerio De Peppo [7], Elena Cremaschi [8], Tommaso Dominioni [9], Alessandro Cucchetti [11], Michele Ciola [12], Montuori Mauro [13], Davide Cossola [15], Pio Corleone [15], Luca Salvador [16], Angelo Franceschi [18], Valentina Sega [19], Luca Pennacchi [20].
Publisher Copyright:
© 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2021
Y1 - 2021
N2 - Background and aims: We investigated the clinical impact of the newly defined metabolic-associated fatty liver disease (MAFLD) in patients undergoing hepatectomy for HCC (MAFLD-HCC) comparing the characteristics and outcomes of patients with MAFLD-HCC to viral- and alcoholic-related HCC (HCV-HCC, HBV-HCC, A-HCC). Methods: A retrospective analysis of patients included in the He.RC.O.Le.S. Group registry was performed. The characteristics, short- and long-term outcomes of 1315 patients included were compared according to the study group before and after an exact propensity score match (PSM). Results: Among the whole study population, 264 (20.1%) had MAFLD-HCC, 205 (15.6%) had HBV-HCC, 671 (51.0%) had HCV-HCC and 175 (13.3%) had A-HCC. MAFLD-HCC patients had higher BMI (p < 0.001), Charlson Comorbidities Index (p < 0.001), size of tumour (p < 0.001), and presence of cirrhosis (p < 0.001). After PSM, the 90-day mortality and severe morbidity rates were 5.9% and 7.1% in MAFLD-HCC, 2.3% and 7.1% in HBV-HCC, 3.5% and 11.7% in HCV-HCC, and 1.2% and 8.2% in A-HCC (p = 0.061 and p = 0.447, respectively). The 5-year OS and RFS rates were 54.4% and 37.1% in MAFLD-HCC, 64.9% and 32.2% in HBV-HCC, 53.4% and 24.7% in HCV-HCC and 62.0% and 37.8% in A-HCC (p = 0.345 and p = 0.389, respectively). Cirrhosis, multiple tumours, size and satellitosis seems to be the independent predictors of OS. Conclusion: Hepatectomy for MAFLD-HCC seems to have a higher but acceptable operative risk. However, long-term outcomes seems to be related to clinical and pathological factors rather than aetiological risk factors.
AB - Background and aims: We investigated the clinical impact of the newly defined metabolic-associated fatty liver disease (MAFLD) in patients undergoing hepatectomy for HCC (MAFLD-HCC) comparing the characteristics and outcomes of patients with MAFLD-HCC to viral- and alcoholic-related HCC (HCV-HCC, HBV-HCC, A-HCC). Methods: A retrospective analysis of patients included in the He.RC.O.Le.S. Group registry was performed. The characteristics, short- and long-term outcomes of 1315 patients included were compared according to the study group before and after an exact propensity score match (PSM). Results: Among the whole study population, 264 (20.1%) had MAFLD-HCC, 205 (15.6%) had HBV-HCC, 671 (51.0%) had HCV-HCC and 175 (13.3%) had A-HCC. MAFLD-HCC patients had higher BMI (p < 0.001), Charlson Comorbidities Index (p < 0.001), size of tumour (p < 0.001), and presence of cirrhosis (p < 0.001). After PSM, the 90-day mortality and severe morbidity rates were 5.9% and 7.1% in MAFLD-HCC, 2.3% and 7.1% in HBV-HCC, 3.5% and 11.7% in HCV-HCC, and 1.2% and 8.2% in A-HCC (p = 0.061 and p = 0.447, respectively). The 5-year OS and RFS rates were 54.4% and 37.1% in MAFLD-HCC, 64.9% and 32.2% in HBV-HCC, 53.4% and 24.7% in HCV-HCC and 62.0% and 37.8% in A-HCC (p = 0.345 and p = 0.389, respectively). Cirrhosis, multiple tumours, size and satellitosis seems to be the independent predictors of OS. Conclusion: Hepatectomy for MAFLD-HCC seems to have a higher but acceptable operative risk. However, long-term outcomes seems to be related to clinical and pathological factors rather than aetiological risk factors.
KW - Hepatectomy
KW - Hepatocellular carcinoma
KW - Liver resection
KW - Metabolic associated fatty liver disease
KW - Metabolic syndrome
KW - NAFLD
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U2 - 10.1016/j.ejso.2021.07.015
DO - 10.1016/j.ejso.2021.07.015
M3 - Article
AN - SCOPUS:85111309660
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
ER -