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World J Hepatol. Feb 27, 2022; 14(2): 354-371
Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.354
Hepatocellular carcinoma in patients with metabolic dysfunction-associated fatty liver disease: Can we stratify at-risk populations?
Eduardo Fassio, Fernando J Barreyro, M Soledad Pérez, Diana Dávila, Graciela Landeira, Gisela Gualano, Gabriela Ruffillo
Eduardo Fassio, M Soledad Pérez, Diana Dávila, Graciela Landeira, Gisela Gualano, Gabriela Ruffillo, Hepatology Section, Gastroenterology Service, Hospital Nacional Prof. Alejandro Posadas, El Palomar 1684, Buenos Aires, Argentina
Fernando J Barreyro, Biotechnology Institute of Misiones, Faculty of Chemical and Natural Sciences, National University of Misiones, Posadas N3300, Misiones, Argentina
Author contributions: This is not a research article but a review work; all authors contributed equally to the bibliographic search, to the reading and interpretation of the selected articles; Fassio E and Barreyro FJ wrote most of the text; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Authors have nothing to declare with respect to this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eduardo Fassio, MD, Chief of Gastroenterology Service, Hepatology Section, Gastroenterology Service, Hospital Nacional Prof. Alejandro Posadas, Av. Presidente Illia y Marconi, s/n, El Palomar 1684, Buenos Aires, Argentina. efassio@intramed.net
Received: March 18, 2021
Peer-review started: March 18, 2021
First decision: July 18, 2021
Revised: August 22, 2021
Accepted: January 25, 2022
Article in press: January 25, 2022
Published online: February 27, 2022
Processing time: 341 Days and 7.8 Hours
Core Tip

Core Tip: Metabolic dysfunction-associated fatty liver disease (MAFLD) affects 25% of general population worldwide. Within that huge number of patients, a minority will progress to cirrhosis, with an annual incidence rate of hepatocellular carcinoma (HCC) > 1%. In them, surveillance for HCC by means of ultrasound with or without alpha-fetoprotein measurement is cost-effective. In patients with MAFLD cirrhosis who are men, older and diabetic, risk is even higher and magnetic resonance imaging might be a better screening test. However, the great challenge is stratifying the HCC risk in patients with MAFLD without cirrhosis. Factors that can help to stratify their risk (genetic, demographic, metabolic, non-invasive fibrosis tests) will be reviewed.