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World J Gastroenterol. Mar 28, 2010; 16(12): 1436-1441
Published online Mar 28, 2010. doi: 10.3748/wjg.v16.i12.1436
Nonalcoholic steatohepatitis-associated hepatocellular carcinoma: Our case series and literature review
Yoshitaka Takuma, Kazuhiro Nouso
Yoshitaka Takuma, Department of Gastroenterology, Kurashiki Central Hospital, Okayama 710-8602, Japan; Department of Internal Medicine, National Hospital Organization Iwakuni Clinical Center, Yamaguchi 740-8510, Japan
Kazuhiro Nouso, Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
Author contributions: Takuma Y and Nouso K reviewed the literature and wrote the paper.
Correspondence to: Yoshitaka Takuma, MD, PhD, Department of Gastroenterology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. takuma@enjoy.ne.jp
Telephone: +81-86-4220120 Fax: +81-86-4213424
Received: November 29, 2009
Revised: December 24, 2009
Accepted: December 31, 2009
Published online: March 28, 2010
Abstract

Recently, nonalcoholic steatohepatitis (NASH) has been considered to be another cause of liver cirrhosis and hepatocellular carcinoma (HCC). The natural history and prognosis of NASH are controversial. Accordingly, we assessed the clinicopathological features of NASH-associated HCC in our experience and reviewed the literature of NASH-associated HCC. We experienced 11 patients with NASH-associated HCC (6 male, 5 female; mean age 73.8 ± 4.9 years) who received curative treatments. Most (91%) patients had been diagnosed with obesity, diabetes, hypertension, or dyslipidemia. Seven patients (64%) also had a non-cirrhotic liver. The recurrence-free survival rates at 1, 3 and 5 years were 72%, 60%, and 60%. We also summarized and reviewed 94 cases of NASH-associated HCC which were reported in the literature (64 male; mean age 66 years). The majority of patients (68%) were obese, 66% of patients had diabetes, and 24% had dyslipidemia. Furthermore, 26% of the HCCs arose from the non-cirrhotic liver. In conclusion, patients with non-cirrhotic NASH may be a high-risk group for HCC, and regular surveillance for HCC is necessary in non-cirrhotic NASH patients as well as cirrhotic patients.

Keywords: Nonalcoholic steatohepatitis; Hepatocellular carcinoma; Nonalcoholic fatty liver disease; Cryptogenic cirrhosis