{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:32:06Z","timestamp":1760149926076,"version":"build-2065373602"},"reference-count":86,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Non-alcoholic fatty liver disease (NAFLD) has gained attention in the last few years due to its increasing prevalence worldwide becoming a global epidemic. The increasing incidence of NAFLD and the concurrent increase in the number of hepatocellular carcinoma (HCC) cases at a global level is a matter of concern. HCC has several risk factors, of which NAFLD and its associated metabolic disturbances\u2014type 2 diabetes mellitus, obesity, and dyslipidemia\u2014are of great interest due to their accelerating rise in incidence worldwide. There is a high amount of data derived from basic and clinical studies that reveal the molecular pathways that drive NAFLD-associated HCC. Based on these findings, new prevention, surveillance, and treatment strategies are emerging. However, current data on treatment modalities in NAFLD-associated HCC are still scarce, though the results from non-NAFLD HCC studies are promising and could provide a basis for a future research agenda to address NAFLD\/NASH patients. Clinicians should carefully assess all the clinical and radiological parameters and establish a prognosis based on the Barcelona Clinic Liver Cancer classification and discuss in a multidisciplinary team the treatment strategy. The specific factors associated with NAFLD-associated HCC which can have a negative impact on survival even in patients with early HCC, such as cardiovascular disease, type 2 diabetes, and obesity, should be taken into consideration. This review aims to discuss the latest recommendations regarding the diagnosis and treatment of NAFLD-associated HCC and the remaining challenges.<\/jats:p>","DOI":"10.3390\/life13101987","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T07:42:08Z","timestamp":1695973328000},"page":"1987","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Challenges and Solutions in the Management of Hepatocellular Carcinoma Associated with Non-Alcoholic Fatty Liver Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Ramona","family":"Cadar","sequence":"first","affiliation":[{"name":"Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corina","family":"Lupascu Ursulescu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"Radiology Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9865-5114","authenticated-orcid":false,"given":"Alin Mihai","family":"Vasilescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Trofin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai","family":"Zabara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delia","family":"Rusu-Andriesi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gr. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania"},{"name":"General Surgery and Liver Transplant Clinic, St. Spiridon University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Ciuntu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gr. T. 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