Zhao H, Zhang XW, Li X. Lifestyle factors in hepatocellular carcinoma: From pathogenesis to prognosis. World J Clin Oncol 2025; 16(7): 107723 [DOI: 10.5306/wjco.v16.i7.107723]
Corresponding Author of This Article
He Zhao, MD, Adjunct Associate Professor, Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hezhaoo@gmail.com
Research Domain of This Article
Oncology
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 Clin Oncol. Jul 24, 2025; 16(7): 107723 Published online Jul 24, 2025. doi: 10.5306/wjco.v16.i7.107723
Lifestyle factors in hepatocellular carcinoma: From pathogenesis to prognosis
He Zhao, Xiao-Wu Zhang, Xiao Li
He Zhao, Xiao-Wu Zhang, Xiao Li, Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Co-corresponding authors: He Zhao and Xiao Li.
Author contributions: Zhao H contributed to the overall concept and the writing of the manuscript; Zhang XW contributed to the editing of the manuscript; Li X review the literature; Zhao H and Li X made equal contribution as co-corresponding authors. All authors approved the final version manuscript.
Supported by Chinese Academy of Medical Sciences Initiative for Innovative Medicine, No. 2021-I2M-1-015; the National Natural Science Foundation of China, No. 82330061 and No. 82001937; the Peking Union Medical College Graduate Curriculum Informatization Development Special Fund Project, No. 2024YXX004; and the Science and Education Cultivation Fund of the National Cancer and Regional Medical Center of Shanxi Provincial Cancer Hospital, No. TD2023003.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: He Zhao, MD, Adjunct Associate Professor, Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hezhaoo@gmail.com
Received: April 1, 2025 Revised: April 24, 2025 Accepted: June 7, 2025 Published online: July 24, 2025 Processing time: 116 Days and 0.4 Hours
Abstract
Hepatocellular carcinoma (HCC) represents a major global health burden, ranking third as the leading cause of cancer-related mortality worldwide. This comprehensive review examines the substantial body of evidence linking modifiable lifestyle factors to HCC pathogenesis and clinical outcomes. We systematically evaluate dietary components, alcohol consumption patterns, tobacco use, physical activity levels, and emerging factors including metabolic disorders, psychological stress, and sleep disturbances. These factors collectively influence hepatocarcinogenesis through diverse biological mechanisms, including genotoxic damage, metabolic dysregulation, chronic inflammatory responses, and gut microbiome-mediated pathways. The accumulated data underscore the urgent need to integrate lifestyle interventions into multidisciplinary HCC management.
Core Tip: This review highlights key modifiable factors affecting hepatocellular carcinoma risk and outcomes. A diet that avoids aflatoxins while being rich in fiber, vegetables, coffee and tea provides protective benefits. Alcohol and tobacco cessation, along with regular exercise, significantly reduce risk and improve outcomes. Obesity, diabetes, poor mental health and sleep disorders worsen prognosis, particularly when interacting with viral hepatitis. These findings underscore the importance of personalized prevention strategies and the integration of lifestyle interventions into hepatocellular carcinoma management to address this global health challenge.
