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Journal of Gastrointestinal Surgery

Published in:

01-08-2011 | Original Article

Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

Authors: Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Pavel Vladimirovich Korita, Yoichi Ajioka, Katsuyoshi Hatakeyama

Published in: Journal of Gastrointestinal Surgery | Issue 8/2011

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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Title: Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease
Authors: Toshifumi Wakai
Yoshio Shirai
Jun Sakata
Pavel Vladimirovich Korita
Yoichi Ajioka
Katsuyoshi Hatakeyama
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1540-8

At a glance: The STEP trials

Springer Medicine

Surgical Outcomes for Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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