Metabolic Syndrome Leads to Worse Outcomes For Patients With HBV-Related HCC

September 21, 2022
Kenny Walter

Kenny Walter is an editor with HCPLive. Prior to joining MJH Life Sciences in 2019, he worked as a digital reporter covering nanotechnology, life sciences, material science and more with R&D Magazine. He graduated with a degree in journalism from Temple University in 2008 and began his career as a local reporter for a chain of weekly newspapers based on the Jersey shore. When not working, he enjoys going to the beach and enjoying the shore in the summer and watching North Carolina Tar Heel basketball in the winter.

Concurrent metabolic syndrome was independently linked to a worse overall and recurrence-free survival rates.

Metabolic syndrome is connected to a worse overall survival for patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

A team, led by Ming-Da Wang, MD, Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), identified the association of concurrent metabolic syndrome with long-term prognosis following liver resection for patients with HBV-related HCC.

HBV and HCC

While HBV infections are the main cause of HCC worldwide, metabolic syndrome is also an important and significant risk factor for HCC.

In the multi-center, database study, the investigators identified patients with HBV who underwent curative resection for HCC in China between 2010-2020 and compared long-term oncological prognosis, including overall survival, recurrence-free survival, and early and late recurrences between patients with metabolic syndrome and without metabolic syndrome.

Overall, there were 1753 patients included in the study, 9.3% (n = 163) of which had concurrent metabolic syndrome.

Outcomes With Metabolic Syndrome

Patients with metabolic syndrome had a worse 5-year overall survival compared to patients without metabolic syndrome (47.5% vs. 61.0%; P = 0.010). They also had worse recurrence-free survival rates (28.3% vs. 44.2%; P = 0.003) and a higher 5-year overall recurrence rate (67.3% vs. 53.3%; P = 0.024).

After conducting a multivariate analysis, the investigators found concurrent metabolic syndrome was independently linked to a worse overall survival (HR, 1.300; 95% CI, 1.018-1.660; P = 0.036) and recurrence-free survival rates (HR, 1.314; 95% CI, 1.062-1.627; P = 0.012).

There were also increased rates of late recurrence (HR, 1.470; 95% CI, 1.004-2.151; P = 0.047).

“In HBV-infected patients with HCC, concurrent metabolic syndrome was associated with poorer postoperative long-term oncologic survival outcomes,” the authors wrote. “These results suggested that patients with metabolic syndrome should undergo enhanced surveillance for tumor recurrence even after 2 years of surgery to early detect late HCC recurrence. Whether improving metabolic syndrome can reduce postoperative recurrence of HCC deserves further exploration.”

HCC and HCV

Recently, a team, led by Nobuhiro Hattori, Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, identified the risk factors linked to liver-related and non-liver-related mortality in patients with hepatitis C virus (HCV) following sustained virologic response to direct-acting antiviral agents in HCC and diabetes mellitus.

The results show a cumulative liver-related or non-liver-related mortality rate of 0.00 or 1.29% at year 1, compared to 2.87 or 3.60% at year 3 and 5.10 or 9.46% at year 5.

For liver-related deaths, 90% (n = 9) were from liver cancer, while the most common cause of non-liver-related deaths was malignancy.

After conducting a multivariate analysis using the Cox proportional hazard model, the investigators found diabetes mellitus (HR, 13.1; 95% CI, 2.81–61.3) and a history of hepatocellular carcinoma (HR, 12.8; 95% CI, 2.76–59.2), independently predicted liver-related death. There were no variables linked to non-liver-related death.

The study, “Association of Concurrent Metabolic Syndrome with Long-term Oncological Prognosis Following Liver Resection for Hepatocellular Carcinoma Among Patients with Chronic Hepatitis B Virus Infection: A Multicenter Study of 1753 Patients,” was published online in the Annals of Surgical Oncology.


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