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. 2024 Jul 4;14(1):15405.
doi: 10.1038/s41598-024-65127-9.

Association of modifiable metabolic risk factors and lifestyle with all-cause mortality in patients with hepatocellular carcinoma

Hwi Young Kim  1 , Hye Ah Lee  2 , Pompilia Radu  3 , Jean-François Dufour  4
Affiliations

Association of modifiable metabolic risk factors and lifestyle with all-cause mortality in patients with hepatocellular carcinoma

Hwi Young Kim et al. Sci Rep. .

Abstract

We aimed to investigate the potential impact of metabolic risk factors and lifestyles on mortality in hepatocellular carcinoma (HCC) patients. From the Korean Central Cancer Registry database (2008-2016), 8,505 HCC patients were included in the analysis. Patients with 2 or more metabolic risk factors (n = 2384, 28.0%) showed significantly worse overall survival (OS, 29 months, 95% confidence interval [CI] 27-33) than patients with 0 (n = 2269 [26.7%]; 41 months, 95% CI 37-47), or 1 (n = 3852 [45.3%]; 42 months; 95% CI 38-46) metabolic risk factor. (P < 0.001) In the multivariable Cox analysis, patients with ≥ 2 metabolic risk factors had significantly elevated risk of overall mortality (adjusted hazards ratio (HR) = 1.14 [95% CI 1.06-1.23], P < 0.001) and HCC-specific mortality (sub-distribution HR = 1.09 [95% CI 1.00-1.09], P = 0.046), compared to those without. Alcohol and smoking were also independent risk factors for worse overall and HCC-specific mortality (all P < 0.05). Metabolic comorbidities were associated with greater risk of mortality in a dose-dependent manner in HCC patients, regardless of tumor stage and liver function. Alcohol intake and smoking significantly increased mortality by themselves and even further with the presence of metabolic risk.

Keywords: Comorbidity; Hepatocellular carcinoma; Lifestyle; Survival.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of patient selection.
Figure 2
Figure 2
Kaplan–Meier curves for overall survival according to the number of metabolic risk factors (P < 0.001 by log-rank test).
See this image and copyright information in PMC

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References

    1. Sung H, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Kulik L, El-Serag HB. Epidemiology and management of hepatocellular carcinoma. Gastroenterology. 2019;156:477–491. doi: 10.1053/j.gastro.2018.08.065. - DOI - PMC - PubMed
    1. Younossi ZM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): A systematic review. Hepatology. 2023;77:1335–1347. doi: 10.1097/HEP.0000000000000004. - DOI - PMC - PubMed
    1. Tan DJH, et al. Global burden of liver cancer in males and females: Changing etiological basis and the growing contribution of NASH. Hepatology. 2023;77:1150–1163. doi: 10.1002/hep.32758. - DOI - PubMed
    1. Younossi Z, et al. Global perspectives on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2019;69:2672–2682. doi: 10.1002/hep.30251. - DOI - PubMed