Journal of Gastroenterology

, Volume 45, Issue 9, pp 960–967

Prospective study of hepatocellular carcinoma in nonalcoholic steatohepatitis in comparison with hepatocellular carcinoma caused by chronic hepatitis C

  • Katsutoshi Tokushige
  • Etsuko Hashimoto
  • Satoru Yatsuji
  • Maki Tobari
  • Makiko Taniai
  • Nobuyuki Torii
  • Keiko Shiratori
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-010-0237-1

Cite this article as:
Tokushige, K., Hashimoto, E., Yatsuji, S. et al. J Gastroenterol (2010) 45: 960. doi:10.1007/s00535-010-0237-1

Abstract

Background

This study was performed to clarify the outcomes and recurrence of hepatocellular carcinoma (HCC) in nonalcoholic steatohepatitis (NASH) in comparison with the data for HCC caused by hepatitis C virus (HCV) infection.

Methods

Data for 34 NASH patients with HCC (NASH-HCC) were analyzed prospectively, and data for 56 age- and sex-matched patients with HCC due to HCV chronic liver disease (HCV-HCC) were collected retrospectively. After the initial treatment for HCC, patients were followed regularly at least every 4 months by performing clinical examinations, serum liver function tests, monitoring alpha-fetoprotein and des-gamma-carboxy prothrombin, and utilizing various imaging modalities.

Results

The five-year survival rate was 55.2% and the cumulative recurrence of HCC at 5 years was 69.8% in treated cases of NASH-HCC. The NASH-HCC and HCV-HCC groups showed similar survival and recurrence rates. Of the 16 NASH-HCC patients curatively treated, recurrence was detected more than 2 years after the initial treatment in 9. Three patients showed intrahepatic recurrences away from the initial HCC, and 3 patients showed a change in tumor marker production after treatment of the initial HCC. The size of the HCC and the stage of fibrosis were significant risk factors for HCC recurrence in NASH-HCC.

Conclusions

HCC recurrence was very high in NASH, and the HCC may be of multicentric origin, similar to HCC based on viral hepatitis. Regular screening for HCC is extremely important for NASH patients with HCC, even after curative treatment. This study confirmed that NASH-HCC has a similar course to that of HCV-HCC.

Keywords

Nonalcoholic steatohepatitis Hepatocellular carcinoma Natural history Recurrence 

Abbreviations

HCC

Hepatocellular carcinoma

NASH

Nonalcoholic steatohepatitis

HCV

Hepatitis C virus

NASH-HCC

NASH patients with HCC

HCV-HCC

HCC due to HCV chronic liver disease

Copyright information

© Springer 2010

Authors and Affiliations

  • Katsutoshi Tokushige
    • 1
  • Etsuko Hashimoto
    • 1
  • Satoru Yatsuji
    • 1
  • Maki Tobari
    • 1
  • Makiko Taniai
    • 1
  • Nobuyuki Torii
    • 1
  • Keiko Shiratori
    • 1
  1. 1.Department of Internal Medicine and GastroenterologyTokyo Women’s Medical UniversityTokyoJapan

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