Steatotic Liver Disease Linked to Improved Survival in Patients With Liver Cancer

Steatotic liver disease (SLD) was linked to improved survival in patients with liver cancer who underwent radiofrequency ablation (RFA).

After a median follow up of 51 months, patients with both liver cancer and steatotic liver disease (SLD; excessive buildup of fat in the liver cells) who received curative radiofrequency ablation (RFA, treatment using electric generated heat) for liver cancer, demonstrated longer survival compared with those without steatotic liver disease, according to a retrospective analysis.

Specifically, the SLD group demonstrated significantly improved liver reserve (liver function), lower cumulative incidences of hepatocellular carcinoma (HCC) recurrence, liver-related mortality and all-cause (death from any cause) mortality rate, according to findings published in Cancer. Patients were further differentiated into groups based on a diagnosis of metabolic function (MD) or no diagnosis, where no association was seen. Of note, SLD was associated with lower all-cause mortality in patients with HCC even after accounting for metabolic dysfunction, liver reserve and HCC characteristics.

Among 598 patients evaluated with HCC, 139 and 459 were classified into SLD and non-SLD groups, respectively. Significantly, there were 31 deaths in the SLD group versus 188 deaths in the non-SLD group. At an average length of 20.9 months and 30.6 months, 99 patients in the SLD group and 345 patients in the non-SLD group developed recurrent HCC. Regarding reasons for death, 28 patients and 162 patients were classified as liver-related deaths in the SLD and non-SLD groups, respectively. One patient in the SLD group and seven in the non-SLD group were classified as CV-related deaths. Of significance, the SLD group exhibited fewer HCC recurrences after curative RFA, fewer liver-related deaths and a lower all-cause mortality rate, compared with those in non-SLD group.

“In conclusion, the present data suggest that concurrent SLD is protective against all‐cause mortality in patients with HCC receiving curative RFA,” study authors wrote. “ALBI grade is an important predictor for mortality. Further research is needed to investigate the protective mechanism of SLD for HCC.”

Patients with HCC who received a lower ALBI grade, indicating better liver function, had a lower risk of death, especially those with HCC does dependently.

Patients in the SLD group had better liver function, as indicated by lower FIB-4 (degree of hepatic fibrosis) and ALBI scores. They were also less likely to have cirrhosis or HCV infection. However, they were more likely to have metabolic dysfunction (MD), diabetes (DM), and a history of smoking or alcohol consumption.

SLD has been associated with an increased risk for hepatocellular carcinoma; a common type of cancer that begins in the liver cells. Authors noted that maintaining good liver function is imperative for prognostic factor survival.

RFA is often chosen for patients with poor liver function or other health problems that make surgery risky, researchers stated in Cancer, noting that It's possible that the older, more cirrhotic patients in the RFA group were more likely to benefit from SLD and its associated better liver health.

Supporting this trial’s evidence, a previous study found that patients with fatty liver disease who had surgery for liver cancer lived longer and had a lower risk of the cancer coming back. The previous study highlights that this might be because these patients were less likely to have advanced liver damage. However, this benefit was only seen in people without severe liver scarring.

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