Ultrasound-guided percutaneous microwave ablation for metabolic-associated fatty liver disease-related hepatocellular carcinoma (HCC) versus hepatitis virus B-related HCC: a propensity score matching study
Creators: name: Qiao, Yannan
name: Chen, Sitong
name: Liu, Yang
name: Li, Lu
name: He, Liting
name: Han, Zhiyu
name: Liu, Fangyi
name: Cheng, Zhigang
name: Yu, Xiaoling
name: Yu, Jie
name: Pang, Chuan
name: Liang, Ping
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Biotechnology
subject: Chemical Sciences not elsewhere classified
subject: Biological Sciences not elsewhere classified
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology

description: To compare the long-term outcomes of microwave ablation (MWA) for primary hepatocellular carcinoma (HCC) in patients with metabolic-associated fatty liver disease (MAFLD) with those infected by hepatitis virus B (HBV). The clinical data of HCC patients under the treatment of MWA were analyzed retrospectively between 2010 and 2021 at Chinese PLA General Hospital. Patients were divided into MAFLD-HCC and HBV-HCC group according to the chronic liver disease etiology. The propensity score matching (PSM) was performed to reduce the interference of confounders. The primary outcomes were overall survival (OS), recurrence-free survival (RFS), cancer-specific survival (CSS) and intrahepatic distant recurrence (IDR). A total of 648 patients (age range, 18–91 years) with 1019 lesions were enrolled including 601 with HBV-HCC and 47 with MAFLD-HCC. After a variable ratio of 1:<i>n</i> ≤ 4 PSM, 100 patients were included in the HBV-HCC and 41 in the MAFLD-HCC group. No statistical differences in OS and CSS (<i>p</i> = 0.880 and <i>p</i> = 0.980, respectively) were observed between the two groups in the matched cohort, while MAFLD-HCC exhibited better RFS and lower IDR rates compared to HBV-HCC (<i>p</i> = 0.043 and <i>p</i> = 0.041, respectively). Additionally, MAFLD-HCC generated lower ascending range in the liver function indexes like ΔALT (46.7 vs. 98.5, <i>p</i> &lt; 0.001), ΔTBIL (1.9 vs. 7.5, <i>p</i> = 0.001) and ΔAST (38.1 vs. 148.6, <i>p</i> &lt; 0.001) than HBV-HCC after MWA. MWA is an effective treatment for HCC patients with MAFLD. The recurrence prognosis of MAFLD-HCC was better than HBV-HCC and the degree of liver injury after MWA was lower. MAFLD-HCC exhibited better recurrence-free survival and lower intrahepatic distance metastasis rates compared with HBV-HCC (<i>p</i> = 0.043 and <i>p</i> = 0.041, respectively).MAFLD-HCC generated lower ascending range in the liver function indexes than HBV-HCC after MWA on the first day.After PSM, MAFLD-HCC displayed better prognosis on recurrence-free survival and intrahepatic distance recurrence in almost all subgroups. MAFLD-HCC exhibited better recurrence-free survival and lower intrahepatic distance metastasis rates compared with HBV-HCC (<i>p</i> = 0.043 and <i>p</i> = 0.041, respectively). MAFLD-HCC generated lower ascending range in the liver function indexes than HBV-HCC after MWA on the first day. After PSM, MAFLD-HCC displayed better prognosis on recurrence-free survival and intrahepatic distance recurrence in almost all subgroups.