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Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The present study investigated outcomes following surgical resection of hepatocellular carcinoma (HCC) in nonalcoholic fatty liver disease (NAFLD).

Methods

Patients (n = 225) undergoing resection for HCC were divided into three groups: hepatitis C viral group (n = 147), hepatitis B viral group (n = 61), and NAFLD group (n = 17). Clinicopathological characteristics and surgical outcomes were analyzed retrospectively.

Results

Patients in the NAFLD group were older (P < 0.001), with a higher body mass index (P < 0.001) and larger tumors (P = 0.002) than patients who were positive for hepatitis viral markers. Eight patients in the NAFLD group were found to have nonalcoholic steatohepatitis (NASH) histologically. Postoperative morbidity and 30-day mortality rates were significantly higher in the NAFLD group (59% and 12%, respectively) than in the hepatitis C viral (31% and 0.7%, respectively) and hepatitis B viral (28% and 3.3%; P = 0.043 and P = 0.016, respectively) groups. All deaths in the NAFLD group were in patients with NASH-related cirrhosis who had undergone right hemihepatectomy. Survival after resection was comparable among the three groups (P = 0.391), but patients with NAFLD showed better disease-free survival on univariate (P = 0.048) and multivariate (P = 0.020) analyses.

Conclusions

Surgical resection may provide a survival benefit for patients with NAFLD-related HCC. Patients with NASH-related cirrhosis undergoing major hepatic resection should be treated carefully.

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    Toshifumi Wakai, Yoshio Shirai, Jun Sakata & Katsuyoshi Hatakeyama

  2. Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Pavel Vladimirovich Korita & Yoichi Ajioka

Authors
  1. Toshifumi Wakai
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  2. Yoshio Shirai
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  6. Katsuyoshi Hatakeyama
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Correspondence to Toshifumi Wakai.

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Wakai, T., Shirai, Y., Sakata, J. et al. Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease. J Gastrointest Surg 15, 1450–1458 (2011). https://doi.org/10.1007/s11605-011-1540-8

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  • DOI: https://doi.org/10.1007/s11605-011-1540-8

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