Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 003] The Paradox of Bodyweight: Lean, But Not Obese, As a Predictor of Poor Prognosis after Surgical Resection for NAFLD-associated Hepatocellular Carcinoma
Wei ZHANG 1, Min-Yu LI 2, Zi-Qiang LI 3, Yong-Kang DIAO 1, Xing-Kai LIU 4, Hong-Wei GUO 5, Xiao-Chang WU 6, Hong WANG 7, Guo-Yue LV 4, Tian YANG 1
1 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA, 2 Special Care Unit, The First Affiliated Hospital of Naval Medical University, CHINA, 3 Liver Transplantation And Hepatic Surgery, First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, CHINA, 4 Hepatobiliary And Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, CHINA, 5 The 2nd Department of General Surgery, The Second People’s Hospital of Changzhi, CHINA, 6 Hepatobiliary Surgery, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, CHINA, 7 General Surgery, Liuyang People’s Hospital, CHINA
Background : Non-alcoholic fatty liver disease (NAFLD) poses a rising risk for hepatocellular carcinoma (HCC), intensified by the global obesity epidemic. Despite obesity being a primary NAFLD and HCC factor, "lean NAFLD" incidence is not uncommon. This study evaluates preoperative body mass index (BMI) influence on long-term prognosis in NAFLD-HCC patients post-surgical resection.
Methods : Data from early-stage NAFLD-HCC patients (BCLC stage 0/A) undergoing curative resection were extracted from an Asian multicenter database. Patients were categorized by preoperative BMI into lean (<23.0 kg/m2), overweight (23.0-27.4 kg/m2), and obese (≥27.5 kg/m2) groups. Long-term overall survival (OS) and recurrence-free survival (RFS) rates were compared.
Results : The study included 309 NAFLD-HCC patients (21.3% lean, 57.0% overweight, 21.7% obese). Liver, tumor, and surgery-related characteristics were similar. Lean patients exhibited poorer 5-year OS (55.4%) and RFS (35.1%) rates than overweight (71.3% OS, 55.6% RFS, P = 0.017, 0.002) and obese patients (48.5% OS, 38.2% RFS, P = 0.939, 0.442). Multivariable analysis identified lean bodyweight, not obese, as an independent predictor of reduced OS (HR: 1.69; 95% CI: 1.06-2.71; P = 0.029) and RFS (HR: 1.72; 95% CI: 1.17-2.52; P = 0.006).
Conclusions : Contrary to obese bodyweight, lean bodyweight is linked to inferior oncological prognosis post-surgical resection in NAFLD-HCC. This underscores the need for in-depth investigation into unique carcinogenic pathways in lean NAFLD-HCC and its implications for HCC recurrence, contributing to BMI-prognosis nuances in surgical interventions for NAFLD-HCC patients.
Methods : Data from early-stage NAFLD-HCC patients (BCLC stage 0/A) undergoing curative resection were extracted from an Asian multicenter database. Patients were categorized by preoperative BMI into lean (<23.0 kg/m2), overweight (23.0-27.4 kg/m2), and obese (≥27.5 kg/m2) groups. Long-term overall survival (OS) and recurrence-free survival (RFS) rates were compared.
Results : The study included 309 NAFLD-HCC patients (21.3% lean, 57.0% overweight, 21.7% obese). Liver, tumor, and surgery-related characteristics were similar. Lean patients exhibited poorer 5-year OS (55.4%) and RFS (35.1%) rates than overweight (71.3% OS, 55.6% RFS, P = 0.017, 0.002) and obese patients (48.5% OS, 38.2% RFS, P = 0.939, 0.442). Multivariable analysis identified lean bodyweight, not obese, as an independent predictor of reduced OS (HR: 1.69; 95% CI: 1.06-2.71; P = 0.029) and RFS (HR: 1.72; 95% CI: 1.17-2.52; P = 0.006).
Conclusions : Contrary to obese bodyweight, lean bodyweight is linked to inferior oncological prognosis post-surgical resection in NAFLD-HCC. This underscores the need for in-depth investigation into unique carcinogenic pathways in lean NAFLD-HCC and its implications for HCC recurrence, contributing to BMI-prognosis nuances in surgical interventions for NAFLD-HCC patients.
SESSION
E-poster
E-Session 03/21 ALL DAY