Cholankeril G, Patel R, Khurana S, Satapathy SK. Hepatocellular carcinoma in non-alcoholic steatohepatitis: Current knowledge and implications for management. World J Hepatol 2017; 9(11): 533-543 [PMID: 28469809 DOI: 10.4254/wjh.v9.i11.533]
Corresponding Author of This Article
Sanjaya K Satapathy, MBBS, MD, DM, FACG, FASGE, Associate Professor of Surgery Transplant Hepatologist, Division of Gastroenterology and Hepatology, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, 1211 Union Avenue, Suite 340, Memphis, TN 38104, United States. ssatapat@uthsc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Apr 18, 2017; 9(11): 533-543 Published online Apr 18, 2017. doi: 10.4254/wjh.v9.i11.533
Hepatocellular carcinoma in non-alcoholic steatohepatitis: Current knowledge and implications for management
George Cholankeril, Ronak Patel, Sandeep Khurana, Sanjaya K Satapathy
George Cholankeril, Sanjaya K Satapathy, Division of Gastroenterology and Hepatology, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN 38104, United States
Ronak Patel, Department of Medicine, University of Alabama at Birmingham, Montgomery Health Center, Montgomery, AL 36116, United States
Sandeep Khurana, Division of Gastroenterology, Georgia Regents University, Augusta, GA 30912, United States
Author contributions: Cholankeril G was responsible for drafting the article, critical revision of the article and approval of the article; Patel R was responsible for drafting the article, critical revision of the article and approval of the article; Khurana S was responsible for critical revision of the article, intellectual input, and approval of the article; Satapathy SK was responsible for the concept/design, drafting the article, critical revision of the article and approval of the article.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose related to the research or data presented in this manuscript. There was no funding for this study. This manuscript is not being considered for publication elsewhere.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sanjaya K Satapathy, MBBS, MD, DM, FACG, FASGE, Associate Professor of Surgery Transplant Hepatologist, Division of Gastroenterology and Hepatology, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, 1211 Union Avenue, Suite 340, Memphis, TN 38104, United States. ssatapat@uthsc.edu
Telephone: +1-901-5169179 Fax: +1-901-5168993
Received: July 29, 2016 Peer-review started: July 31, 2016 First decision: September 8, 2016 Revised: February 25, 2017 Accepted: March 14, 2017 Article in press: March 14, 2017 Published online: April 18, 2017 Processing time: 258 Days and 3.1 Hours
Abstract
With the prevalence of hepatitis C virus expected to decline, the proportion of hepatocellular carcinoma (HCC) related to non-alcoholic steatohepatitis (NASH) is anticipated to increase exponentially due to the growing epidemic of obesity and diabetes. The annual incidence rate of developing HCC in patients with NASH-related cirrhosis is not clearly understood with rates ranging from 2.6%-12.8%. While multiple new mechanisms have been implicated in the development of HCC in NASH; further prospective long-term studies are needed to validate these findings. Recent evidence has shown a significant proportion of patients with non-alcoholic fatty liver disease and NASH progress to HCC in the absence of cirrhosis. Liver resection and transplantation represent curative therapeutic options in select NASH-related HCC patients but have placed a significant burden to our healthcare resources and utilization. Currently NASH-related HCC is the fastest growing indication for liver transplant in HCC candidates. Increased efforts to implement effective screening and preventative strategies, particularly in non-cirrhotic NASH patients, are needed to reduce the future impact imposed by NASH-related HCC.
Core tip: Non-alcoholic steatohepatitis (NASH) is anticipated to account for a greater proportion of hepatocellular carcinoma (HCC) incidence due to the growing epidemic of obesity and diabetes. Currently NASH-related HCC is the fastest growing indication for liver transplant in HCC candidates. Increased efforts to implement effective screening and preventative strategies particularly in non-cirrhotic NASH patients possibly based on genetic susceptibility are needed to reduce the future impact imposed by NASH-related HCC.
