{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:00:20Z","timestamp":1790247620773,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T00:00:00Z","timestamp":1504137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"European Union's Horizon 2020 research"},{"name":"EPoS (Elucidating Pathways of Steatohepatitis)","award":["634413"],"award-info":[{"award-number":["634413"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>) worldwide. <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> often occurs in noncirrhotic liver raising important surveillance issues.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the temporal trends for prevalence, clinical characteristics and outcomes of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> in patients undergoing liver resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with histologically confirmed <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> who underwent liver resection over a 20\u2010year period (1995\u20102014). <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> was diagnosed based on past or present exposure to obesity or diabetes without other causes of chronic liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 323 <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> patients were included, 12% with <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>. From 1995\u20101999 to 2010\u20102014, the prevalence of <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> increased from 2.6% to 19.5%, respectively, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003, and followed the temporal trends in the prevalence of metabolic risk factors (28% vs 52%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.017), while hepatitis C\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> decreased (from 43.6% to 19.5%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003). <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> occurred more frequently in the absence of bridging fibrosis\/cirrhosis (63% of cases, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 compared to other aetiologies). Within the <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> group, tumour characteristics were similar between F0\u2010F2 and F3\u2010F4 patients, except for a higher proportion of single nodules (95% vs 54%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01).<\/jats:p><jats:p>A total of 53% patients had tumour recurrence and 40% died. <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> had similar time to recurrence and survival as <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s of other aetiologies. Satellite nodules, tumour size, microvascular invasion and male sex but not the aetiology were independently associated with recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Non\u2010alcoholic fatty liver disease increased substantially over the past 20\u00a0years among resectable <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s. It is now the leading cause of <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> occuring without\/or with only minimal fibrosis. <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content> patients are older, with larger tumours while survival and recurrence rates are as severe as in other aetiologies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14261","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T12:02:15Z","timestamp":1504180935000},"page":"856-863","source":"Crossref","is-referenced-by-count":116,"title":["Temporal trends, clinical patterns and outcomes of <scp>NAFLD<\/scp>\u2010related <scp>HCC<\/scp> in patients undergoing liver resection over a 20\u2010year period"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8070-0733","authenticated-orcid":false,"given":"R.","family":"Pais","sequence":"first","affiliation":[{"name":"Service H\u00e9patogastroent\u00e9rologie Assistance 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