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Review
. 2017 Jul;4(3):83-98.
doi: 10.2217/hep-2017-0013. Epub 2017 Oct 30.

Nonalcoholic fatty liver disease and hepatocellular carcinoma

Stephanie Klein  1   2   1   2 , Jean-François Dufour  1   2   1   2
Affiliations
Review

Nonalcoholic fatty liver disease and hepatocellular carcinoma

Stephanie Klein et al. Hepat Oncol. 2017 Jul.

Abstract

Hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease is becoming more common globally. The incidence of HCC due to nonalcoholic steatohepatitis in comparison to other etiologies is increasing. This is due to the pandemic of obesity and diabetes mellitus, two important risk factors for HCC. HCC arising in this context occurs in about 40% of the cases in a liver which is not yet cirrhotic. This has implications regarding the population which should be enrolled in an HCC surveillance program and regarding the treatment options. Surgery is more frequently contemplated in patients with HCC and no cirrhosis. However, patients with nonalcoholic steatohepatitis-induced HCC have frequent co-morbidities which have to be taken into account when developing a management strategy. Interestingly, these patients are frequently on medications which have been suggested to decrease the risk to develop HCC.

Keywords: diabetes mellitus; obesity; resection.

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Conflict of interest statement

Financial & competing interests disclosure JF Dufour is on the advisory committees of Abbvie, Bayer, BMS, Falk, Genfit, Gilead Science, Intercept, Lilly, Merck and Novartis. JF Dufour has received speaking and teaching fees from Abbvie, Bayer, BMS, Genfit, Gilead Science and Novartis. He has also received an unrestricted research grant from Bayer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Clinical characteristics of a hepatocellular carcinoma in the context of nonalcoholic steatohepatitis in an older woman with arterial hypertension, obesity and diabetes mellitus.
She has a large infiltrative HCC in a steatotic, noncirrhotic liver. Her risk for HCC is mitigated by her medication with metformin, statin and aspirin. HCC: Hepatocellular carcinoma.
See this image and copyright information in PMC

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