The beneficial impact of metabolic dysfunction‐associated fatty liver disease on lenvatinib treatment in patients with non‐viral hepatocellular carcinoma

Aim Lenvatinib is used to treat advanced hepatocellular carcinoma (HCC). Metabolic dysfunction‐associated fatty liver disease (MAFLD) is becoming a major etiology of HCC. We aimed to evaluate the impact of MAFLD on the efficacy of lenvatinib. Methods We enrolled 320 patients with HCC who were treate...

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Published in:Hepatology research 2023-02, Vol.53 (2), p.104-115
Main Authors: Shimose, Shigeo, Hiraoka, Atsushi, Casadei‐Gardini, Andrea, Tsutsumi, Tsubasa, Nakano, Dan, Iwamoto, Hideki, Tada, Fujimasa, Rimini, Margherita, Tanaka, Masatoshi, Torimura, Takuji, Suga, Hideya, Ohama, Hideko, Burgio, Valentina, Niizeki, Takashi, Moriyama, Etsuko, Suzuki, Hiroyuki, Shirono, Tomotake, Noda, Yu, Kamachi, Naoki, Nakano, Masahito, Kuromatsu, Ryoko, Koga, Hironori, Kawaguchi, Takumi
Format: Article
Language:English
Subjects:
Bilirubin
Etiology
Fatty liver
Hepatocellular carcinoma
lenvatinib
Liver cancer
Liver diseases
metabolic dysfunction‐associated fatty liver disease
Metabolism
Multivariate analysis
non‐viral hepatoma
Risk factors
Survival
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Summary:Aim Lenvatinib is used to treat advanced hepatocellular carcinoma (HCC). Metabolic dysfunction‐associated fatty liver disease (MAFLD) is becoming a major etiology of HCC. We aimed to evaluate the impact of MAFLD on the efficacy of lenvatinib. Methods We enrolled 320 patients with HCC who were treated with lenvatinib. All patients were classified into the MAFLD (n = 155) and non‐MAFLD (n = 165) groups. Independent factors for overall survival (OS) were analyzed. In the stratification analysis, HCC was categorized as non‐viral (n = 115) or viral HCC (n = 205). Results The OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group (median 21.1 vs. 15.1 months, p = 0.002). Multivariate analysis demonstrated that, in addition to albumin‐bilirubin grade and Barcelona Clinic Liver Cancer stage, MAFLD was identified as an independent factor for OS (HR 0.722, 95% CI 0.539–0.966, p = 0.028). In the stratification analysis, the OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group among patients with non‐viral HCC (median 21.1 vs. 15.1 months, p = 0.002), but not in patients with viral HCC. Furthermore, MAFLD was an independent negative risk factor for OS in patients with non‐viral HCC (HR 0.506, 95% CI 0.297–0.864, P 
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.13843