- Hepatocellular carcinoma (HCC) with nonalcoholic fatty liver disease (NAFLD) etiology is associated with greater surgical morbidity and posthepatectomy liver failure, but better 5-year OS.
Why this matters
- NAFLD-associated HCC is becoming increasingly common, but little is known about long-term outcomes after attempted curative resection.
- Retrospective, matched analysis of 996 consecutive patients with HCC undergoing liver resection at a single institution in Singapore; 152 (18.0%) cases were associated with NAFLD.
- Funding: None disclosed.
- Surgical morbidity and postoperative complications were more common with NAFLD vs non-NAFLD HCC:
- Median intraoperative blood loss (500 vs 400 mL; P=.0252).
- Intraoperative transfusions (37.8% vs 28%; P=.0208).
- Minor surgical complications (41.2% vs 24.2%; P<.0001>
- Major surgical complications (16.2% vs 8.1%; P<.0001>
- Liver failure (29.5% vs 9.5% for grade A; 20.1% vs 7.2% for grade B/C; P<.0001>
- Cardiorespiratory complications (11.8% vs 6.8%; P=.0286).
- Pulmonary embolism (2% vs 0.4%; P=.0176).
- Total hospital stay (8 vs 6 days; P<.0001>
- 5-year OS (70.1% vs 60.9%; P=.0355), although there was a nonequal distribution of propensity score between groups (P=.0411).
- NAFLD HCC was associated with better OS (aHR, 0.673; P=.0438).
- Retrospective, monocentric design.