Global Health & Medicine 2026;8(5):363-370.

Association of steatotic liver disease with long-term oncological outcomes after hepatic resection for hepatocellular carcinoma

Hasui N, Funakoshi S, Yamazaki A, Yanase T, Kudo S, Momose H, Matsuki R, Kogure M, Hayashi A, Suzuki Y, Shibahara J, Sakamoto Y

Hepatic steatosis manifests in obesity and systemic metabolic disorders. The nomenclature has recently shifted from nonalcoholic fatty liver disease/nonalcoholic steatohepatitis to steatotic liver disease (SLD), which includes metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated steatotic liver disease with increased alcohol intake, and alcohol-related liver disease. This study retrospectively evaluated the association between SLD and long-term oncological outcomes in 85 patients undergoing hepatic resection for hepatocellular carcinoma (HCC) between 2018 and 2022. SLD was histologically defined as steatosis involving ≥ 5% of non-tumorous hepatocytes. Of these patients, 47 did not have SLD (non-SLD group) and 38 had SLD. We compared recurrence-free survival (RFS) and overall survival (OS) between these groups. Patients with SLD exhibited a higher body mass index and more advanced fibrosis than those without SLD, whereas lifestyle-related diseases were comparably prevalent. Median RFS was not reached in the non-SLD group and was 21 months in the SLD group (log-rank p = 0.054). In exploratory multivariable analysis, SLD was associated with a higher cause-specific hazard of recurrence after adjustment for age, Barcelona Clinic Liver Cancer stage, viral hepatitis status, and diabetes mellitus (adjusted hazard ratio, 1.939; 95% confidence interval, 1.003–3.748). No significant association between SLD and OS was noted (hazard ratio, 0.962; 95% confidence interval, 0.399–2.315). These findings suggest a possible association between SLD and HCC recurrence after hepatic resection, whereas its association with OS remains uncertain.

DOI: 10.35772/ghm.2026.01056

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