Lower hepatocellular carcinoma surveillance in metabolic dysfunction-associated steatotic liver disease: Impact on treatment eligibility

被引:0
|
作者
Henry-Blake, Connor [1 ]
Balachandrakumar, Vinay [1 ]
Kassab, Mohamed [1 ]
Devonport, Joshua [1 ]
Matthews, Charmaine [1 ]
Fox, James [1 ]
Baggus, Elisabeth [1 ]
Henney, Alexander [2 ,3 ,4 ,5 ]
Stern, Nicholas [1 ]
Cuthbertson, Daniel J. [2 ,3 ,4 ,5 ]
Palmer, Daniel [6 ]
Johnson, Philip J. [6 ]
Hughes, David M. [7 ]
Hydes, Theresa J. [1 ,3 ,4 ,5 ]
Cross, Timothy J. S. [1 ,6 ]
机构
[1] Liverpool Univ Hosp NHS Fdn Trust, Dept Gastroenterol & Hepatol, Liverpool, England
[2] Liverpool Univ Hosp NHS Fdn Trust, Dept Diabet & Endocrinol, Liverpool, England
[3] Univ Liverpool, Dept Cardiovasc & Metab Med, Liverpool, England
[4] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, England
[5] Liverpool Univ Hosp NHS Fdn Trust, Liverpool, England
[6] Univ Liverpool, Dept Mol & Clin Canc Med, Liverpool, England
[7] Univ Liverpool, Inst Populat Hlth, Dept Hlth Data Sci, Liverpool, England
关键词
early detection of cancer; hepatocellular carcinoma; non-alcoholic fatty liver disease; RISK; PREDICTS; CANCER; NAFLD; HCC;
D O I
10.1111/jgh.16727
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aim: This study aimed to compare the determinants and impact of hepatocellular carcinoma (HCC) surveillance rates for people with metabolic dysfunction-associated steatotic liver disease (MASLD) versus other chronic liver diseases. Methods: A dataset of HCC patients from a UK hospital (2007-2022) was analyzed. The Mann-Whitney U-test compared continuous variables. The chi(2) and two-tailed Fisher exact tests compared categorical data. Regression modeling analyzed the impact of MASLD on the size and number of HCC nodules and curative treatment. The Cox proportional hazards model assessed the influence of MASLD on overall survival. Results: A total of 176 of 687 (25.6%) HCC patients had MASLD. Fewer people with MASLD HCC were enrolled in HCC surveillance compared to non-MASLD HCC (38 [21.6%] vs 215 [42.1%], P < 0.001). Patients with MASLD HCC were less likely to have been under secondary care (n = 57 [32.4%] vs 259 [50.7%], P < 0.001) and less likely to have cirrhosis (n = 113 [64.2%] vs 417 [81.6%], P < 0.001). MASLD was associated with a 12.3-mm (95% confidence interval [CI] 10.8-14.0 mm) greater tumor diameter compared to people without MASLD (P = 0.002). Patients with MASLD HCC had 0.62 reduced odds (95% CI 0.43-0.91) of receiving curative treatment compared to non-MASLD HCC (P = 0.014). Overall survival was similar for patients with MASLD HCC versus non-MASLD HCC (hazard ratio 1.03, 95% CI 0.85-1.25, P = 0.748). Conclusion: Patients with MASLD are less likely to have been enrolled in HCC surveillance due to undiagnosed cirrhosis or presenting with non-cirrhotic HCC. Patients with MASLD HCC present with larger tumors and are less likely to receive curative treatment.
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页数:9
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