Anbarasu Centura R, Williams-Perez Sophia, Camp Ernest R, Erstad Derek J
Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Department of Surgery, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
Cancers (Basel). 2024 Aug 6;16(16):2773. doi: 10.3390/cancers16162773.
Hepatocellular carcinoma (HCC) is an aggressive form of liver cancer that arises in a background of chronic hepatic injury. Metabolic syndrome-associated fatty liver disease (MAFLD) and its severe form, nonalcoholic steatohepatitis (NASH), are increasingly common mechanisms for new HCC cases. NASH-HCC patients are frequently obese and medically complex, posing challenges for clinical management. In this review, we discuss NASH-specific challenges and the associated implications, including benefits of minimally invasive operative approaches in obese patients; the value of y90 as a locoregional therapy; and the roles of weight loss and immunotherapy in disease management. The relevant literature was identified through queries of PubMed, Google Scholar, and clinicaltrials.gov. Provider understanding of clinical nuances specific to NASH-HCC can improve treatment strategy and patient outcomes.
肝细胞癌（HCC）是一种侵袭性肝癌，发生于慢性肝损伤背景下。代谢综合征相关脂肪性肝病（MAFLD）及其严重形式非酒精性脂肪性肝炎（NASH）是新发HCC病例越来越常见的机制。NASH-HCC患者常伴有肥胖且病情复杂，给临床管理带来挑战。在本综述中，我们讨论了NASH特有的挑战及其相关影响，包括肥胖患者微创外科手术方法的益处；钇90作为局部区域治疗的价值；以及体重减轻和免疫治疗在疾病管理中的作用。通过查询PubMed、谷歌学术和clinicaltrials.gov确定了相关文献。医疗服务提供者对NASH-HCC特定临床细微差别的理解可以改善治疗策略和患者预后。
