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Updated: May 31, 2026

The Influence of Liver Resection on Intrahepatic Tumor Growth

The Influence of Liver Resection on Intrahepatic Tumor Growth

Published on: April 9, 2016

Burnt-Out MASLD Predicts Outcomes After Curative Resection for Hepatocellular Carcinoma.

Yukihiro Watanabe¹, Masayasu Aikawa¹, Yoshiki Murase¹

¹Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan.

Liver International : Official Journal of the International Association for the Study of the Liver

|May 29, 2026

Summary

The "burnt-out" metabolic dysfunction-associated steatotic liver disease (MASLD) phenotype indicates advanced liver injury and is linked to worse outcomes after hepatocellular carcinoma (HCC) resection.

Keywords:

hepatectomy histopathology liver fibrosis prognosis steatosis tumour recurrence

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Area of Science:

Hepatology
Oncology
Pathology

Background:

Metabolic dysfunction-associated steatotic liver disease (MASLD) can progress to a 'burnt-out' state with diminished steatosis.
The clinical significance of this 'burnt-out' MASLD phenotype in patients with hepatocellular carcinoma (HCC) is not well understood.

Purpose of the Study:

To evaluate the prognostic relevance of the 'burnt-out' MASLD phenotype in patients undergoing curative resection for MASLD-related HCC.

Main Methods:

Retrospective analysis of 931 patients with MASLD-related HCC who underwent curative hepatectomy.
Histologic assessment of steatosis (S) and fibrosis (F) to define four phenotypes, including 'burnt-out' MASLD (S≤1/F≥3).
Evaluation of postoperative complications, recurrence-free survival, and overall survival using Cox proportional hazards models.

Main Results:

'Burnt-out' MASLD was independently associated with a higher risk of HCC recurrence (HR 1.87) and reduced overall survival (HR 3.38).
Perioperative morbidity was not increased in the 'burnt-out' MASLD group.
Histologic analysis showed stable steatosis but potential fibrosis progression after tumor development.

Conclusions:

'Burnt-out' MASLD is a distinct histologic phenotype with significant prognostic implications after HCC resection.
Identifying this phenotype can improve risk stratification and surveillance strategies for patients with MASLD-related HCC.