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

• Published in: Annals of surgical oncology Vol. 30; no. 1; pp. 346 - 358
• Main Authors: Wang, Ming-Da, Tang, Shi-Chuan, Li, Chao, Sun, Li-Yang, Xu, Xiao, Liang, Ying-Jian, Liu, Fu-Bao, Gu, Wei-Min, Wang, Xian-Ming, Zhou, Ya-Hao, Lau, Wan Yee, Zhang, Cheng-Wu, Yao, Lan-Qing, Diao, Yong-Kang, Gu, Li-Hui, Shen, Feng, Zeng, Yong-Yi, Yang, Tian
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.01.2023; Springer Nature B.V
• Subjects: Carcinoma, Hepatocellular - surgery; Chronic infection; Confidence intervals; Hepatectomy; Hepatitis B; Hepatitis B, Chronic - complications; Hepatobiliary Tumors; Hepatocellular carcinoma; Humans; Liver; Liver cancer; Liver Neoplasms - etiology; Liver Neoplasms - surgery; Medical prognosis; Medicine; Medicine & Public Health; Metabolic syndrome; Metabolic Syndrome - complications; Multivariate analysis; Oncology; Patients; Prognosis; Risk factors; Surgery; Surgical Oncology; Survival; Tumors
• ISSN: 1068-9265; 1534-4681; 1534-4681
• DOI: 10.1245/s10434-022-12529-6

Background Although hepatitis B virus (HBV) infection remains the main cause of hepatocellular carcinoma (HCC) worldwide, metabolic syndrome, with its increase in prevalence, has become an important and significant risk factor for HCC. This study was designed to investigate the association of concurrent metabolic syndrome with long-term prognosis following liver resection for patients with HBV-related HCC. Methods From a Chinese, multicenter database, HBV-infected patients who underwent curative resection for HCC between 2010 and 2020 were identified. Long-term oncological prognosis, including overall survival (OS), recurrence-free survival (RFS), and early (≤2 years of surgery) and late (>2 years) recurrences were compared between patients with versus those without concurrent metabolic syndrome. Results Of 1753 patients, 163 (9.3%) patients had concurrent metabolic syndrome. Compared with patients without metabolic syndrome, patients with metabolic syndrome had poorer 5-year OS (47.5% vs. 61.0%; P = 0.010) and RFS (28.3% vs. 44.2%; P = 0.003) rates and a higher 5-year overall recurrence rate (67.3% vs. 53.3%; P = 0.024). Multivariate analysis revealed that concurrent metabolic syndrome was independently associated with poorer OS (hazard ratio: 1.300; 95% confidence interval: 1.018–1.660; P = 0.036) and RFS (1.314; 1.062–1.627; P = 0.012) rates, and increased rates of late recurrence (hazard ratio: 1.470; 95% confidence interval: 1.004–2.151; P = 0.047). Conclusions In HBV-infected patients with HCC, concurrent metabolic syndrome was associated with poorer postoperative long-term oncologic survival outcomes. 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.