Metabolic Risks Are Increasing in Non-B Non-C Early-Stage Hepatocellular Carcinoma: A 10-Year Follow-Up Study

Area of Science:

• Hepatology
• Oncology
• Metabolic Syndrome Research

Background:

• Non-B, non-C hepatocellular carcinoma (NBNC-HCC) incidence is rising, with potential links to metabolic syndrome.
• Metabolic-associated fatty liver disease (MAFLD) is a new concept that may clarify the association between metabolic syndrome and NBNC-HCC.
• Previous research has not extensively applied the MAFLD concept to NBNC-HCC studies.

Purpose of the Study:

• To compare clinicopathological characteristics of NBNC-HCC and CHB-HCC patients.
• To investigate the association of metabolic risk factors and MAFLD with NBNC-HCC.
• To analyze trends in metabolic risk factors and MAFLD in NBNC-HCC patients over two diagnostic periods (2009-13 and 2014-18).

Main Methods:

• Retrospective assessment of patients with BCLC-0/A-HCC who underwent curative hepatectomy from 2009 to 2018.
• Multivariate analysis to examine associations between clinicopathological characteristics and clinical outcomes.
• Comparison of metabolic risk factors and MAFLD prevalence between NBNC-HCC and CHB-HCC groups, and across different time periods.

Main Results:

• NBNC-HCC patients diagnosed in 2014-18 showed significantly higher frequencies of diabetes mellitus (DM), hypertension (HTN), elevated BMI, and MAFLD compared to those diagnosed in 2009-13.
• No significant changes in metabolic disorders were observed in CHB-HCC patients between the two periods.
• CHB-HCC was identified as an independent risk factor for HCC recurrence and mortality compared to NBNC-HCC.

Conclusions:

• The risk of MAFLD, obesity, DM, and HTN has significantly increased in early-stage NBNC-HCC patients, necessitating metabolic syndrome monitoring.
• NBNC-HCC generally exhibits a better prognosis than CHB-HCC, likely due to distinct clinicopathological features.
• The MAFLD concept provides a valuable framework for understanding metabolic contributions to NBNC-HCC.