{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:31:48Z","timestamp":1791999108529,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["LU2185\/2\u20101"],"award-info":[{"award-number":["LU2185\/2\u20101"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Curative surgery for hepatocellular carcinoma (HCC) includes liver resection (LR) and orthotopic liver transplantation (OLT). Due to the obesity epidemic, metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is a frequent HCC aetiology that often coincides with increased alcohol consumption, termed MetALD, or even alcohol\u2010associated liver disease (ALD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing LR or OLT for HCC at Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin (2010\u20132020) were included in this retrospective cohort study investigating disease aetiology, time to recurrence (TTR), overall survival (OS) and CT\u2010based body composition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 579 patients with HCC, 417 underwent LR and 162 OLT. Tumour aetiologies were viral <jats:italic>n<\/jats:italic>\u2009=\u2009191 (33.0%), MASLD <jats:italic>n<\/jats:italic>\u2009=\u2009158 (27.3%), MetALD <jats:italic>n<\/jats:italic>\u2009=\u200951 (8.8%), ALD <jats:italic>n<\/jats:italic>\u2009=\u200968 (11.7%) and other\/cryptogenic <jats:italic>n<\/jats:italic>\u2009=\u2009111 (19.2%). Patients with MASLD and MetALD had more intramuscular (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>p\u2009=<\/jats:italic>\u20090.015) and visceral fat (both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than patients with non\u2010metabolic dysfunction aetiologies. Patients with MASLD\u2010HCC had comparable TTR (median 26\u2009months, [95% CI: 23\u201331] vs. 30\u2009months [95% CI: 4\u201357], <jats:italic>p<\/jats:italic>\u2009=\u20090.425) but shorter OS than patients with other HCC aetiologies (63\u2009months [95% CI: 42\u201384] vs. 80\u2009months [95% CI: 60\u2013100], hazard ratio: 1.53 [95% CI: 1.050\u20132.229], <jats:italic>p<\/jats:italic>\u2009=\u20090.026) after LR. Multivariate analysis confirmed MASLD aetiology, portal vein thrombosis and MELD score \u2265\u200910 as independent prognostic factors for OS in LR (adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.021,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001,<jats:italic>p\u2009=<\/jats:italic>\u20090.003), even after excluding in\u2010hospital mortality (adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.016,<jats:italic>p<\/jats:italic>\u2009=\u20090.002,<jats:italic>p<\/jats:italic>\u2009=\u20090.002). Causes of death were similar in MASLD and non\u2010MASLD aetiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with HCC undergoing LR and meeting the new MASLD criteria have significantly shorter OS. This study provides empirical prognostic evidence for the novel MASLD\/MetALD classification in a large European cohort of patients undergoing curative\u2010intent HCC therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.70002","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T12:59:37Z","timestamp":1739883577000},"page":"1318-1332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Metabolic Dysfunction\u2010Associated Steatotic Liver Disease (<scp>MASLD<\/scp>) Impacts Long\u2010Term Outcomes After Curative\u2010Intent Surgery for Hepatocellular Carcinoma"],"prefix":"10.1111","volume":"61","author":[{"given":"Deniz","family":"Uluk","sequence":"first","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte, Campus Virchow Klinikum Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"},{"name":"Department of General, Visceral and Transplantation 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Hospital  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin V.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Medicine III University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude","family":"Bitar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte, Campus Virchow Klinikum Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Dreher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte, Campus Virchow Klinikum Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Eurich","sequence":"additional","affiliation":[{"name":"Department of Surgery, Campus Charit\u00e9 Mitte, 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