Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Jiao Xue; Qing-Xia Wang; Huan-Ming Xiao; Mei-Jie Shi; Yu-Bao Xie; Sheng Li; Ming Lin; Xiao-Ling Chi

doi:10.2147/CMAR.S368366

Impact of Metabolic Dysfunction Associated Fatty Liver Disease on the Prognosis of Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma Based on Propensity Score Matching Analysis

Cancer Manag Res. 2022 Jul 14:14:2193-2202. doi: 10.2147/CMAR.S368366. eCollection 2022.

Authors

Jiao Xue¹, Qing-Xia Wang¹, Huan-Ming Xiao², Mei-Jie Shi², Yu-Bao Xie², Sheng Li², Ming Lin², Xiao-Ling Chi²

Affiliations

¹ The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, People's Republic of China.
² Department of Hepatology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, People's Republic of China.

Abstract

Purpose: Both metabolic dysfunction-associated fatty liver disease (MAFLD) and hepatitis B virus (HBV) are risk factors for hepatocellular carcinoma (HCC). Although concurrent MAFLD is common in patients with HBV-related HCC, whether MAFLD increases the risk of poor prognosis in patients with HBV-related HCC remains unclear. This study aimed to investigate the impact of MAFLD on prognosis in patients with HBV-related HCC.

Patients and methods: In this retrospective cohort study, 549 patients with HBV-related HCC were enrolled from January 2010 to April 2020 in Guangdong Provincial Hospital of Chinese Medicine, including 169 patients with MAFLD (MAFLD group) and 380 patients without MAFLD (Non-MAFLD group). Propensity score matching (PSM) analysis was performed to balance the baseline characteristics. Kaplan-Meier survival curves were performed to compare the prognosis between the two matched groups. A multivariate Cox proportional hazards model was used to determine the risk factors for poor prognosis.

Results: The median follow-up time for all patients was 20 (interquartile range 8-40) months. We found concurrent MAFLD was associated with a significantly decreased PFS rate before and after PSM analysis. The 1-year, 2-year, and 3-year PFS rates for the MAFLD and Non-MAFLD groups after PSM were 61.3% and 70.8%, 43.9% and 54.5%, 31.1% and 41.8%, respectively. Cox multivariable analysis showed that concurrent MAFLD was an independent risk factor for poor prognosis (death or progression) (HR = 1.49, P = 0.001). More interestingly, the risk of poor prognosis was significantly higher in the MAFLD subtype with metabolic components ≥2 compared to those with metabolic components <2 (HR = 1.97, P < 0.001).

Conclusion: Concurrent MAFLD was associated with a higher risk of poor prognosis in patients with HBV-related HCC, especially MAFLD with metabolic components ≥2.

Keywords: hepatitis B virus; hepatocellular carcinoma; metabolic dysfunction-associated fatty liver disease; poor prognosis.

Grants and funding

The current study was funded by the Thirteen Five-Year Plan for Major and Special Program of the National Science and Technology of China (2018ZX10725506-003 and 2018ZX10725505-004); the biological resources project collaborated by Guangdong Provincial Hospital of Chinese Medicine and Shanghai chip National Engineering Center (YN2016XP03); the Clinical research projects of Guangdong Provincial Hospital of Chinese Medicine (YN10101903) and the Science and Technology research project of Traditional Chinese Medicine of Guangdong Provincial Hospital of Chinese Medicine (YN2022DB04).