Evidence map›Paper›PMID 33238333›Full record

SynthesisClinical and molecular hepatology2021

Obesity and the risk of primary liver cancer: A systematic review and meta-analysis.

Won Sohn, Hyun Woong Lee, Sangheun Lee, Jin Hong Lim, Min Woo Lee, Chan Hyuk Park, Seung Kew Yoon

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical and molecular hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 6 pooled it
11.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 6 syntheses or guidelines pooled it, 176 citations in OpenAlex.

  1. Pooled it
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  7. Review
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  10. Disentangling the Effect of BMI on Hepatocellular Carcinoma From Cirrhosis With Multivariable Mendelian Randomization.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
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  16. Assessment of Adipokine and Inflammation Biomarkers with Cancer Risk among Chinese Men: A Prospective Cohort Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    Article
  17. Review
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25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Won SohnDivision of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hyun Woong LeeDepartment of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sangheun LeeDepartment of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
Jin Hong LimDepartment of General Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Min Woo LeeDepartment of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Chan Hyuk ParkDepartment of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Seung Kew YoonDepartment of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea.
Sungkyunkwan University · KRCatholic Kwandong University · KRGangnam Severance Hospital · KRHanyang University Guri Hospital · KRThe Catholic University of Korea Seoul St. Mary's Hospital · KRYonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsIn this systematic review and meta-analysis, we aimed to clarify the effect of obesity on the occurrence of and mortality from primary liver cancer.

methodsThis study was conducted using a systematic literature search of MEDLINE, EMBASE, and the Cochrane Library until November 2018 using the primary keywords "obesity," "overweight," "body mass index (BMI)," "body weight," "liver," "cancer," "hepatocellular carcinoma," "liver cancer," "risk," and "mortality." Studies assessing the relationship between BMI and occurrence of or mortality from primary liver cancer in prospective cohorts and those reporting hazard ratios (HRs) or data that allow HR estimation were included.

resultsA total of 28 prospective cohort studies with 8,135,906 subjects were included in the final analysis. These included 22 studies with 6,059,561 subjects for cancer occurrence and seven studies with 2,077,425 subjects for cancerrelated mortality. In the meta-analysis, an increase in BMI was associated with the occurrence of primary liver cancer (HR, 1.69; 95% confidence interval, 1.50-1.90, I2=56%). A BMI-dependent increase in the risk of occurrence of primary liver cancer was reported. HRs were 1.36 (95% CI, 1.02-1.81), 1.77 (95% CI, 1.56-2.01), and 3.08 (95% CI, 1.21-7.86) for BMI >25 kg/m2, >30 kg/m2, and >35 kg/m2, respectively. Furthermore, increased BMI resulted in enhanced liver cancer-related mortality (HR, 1.61; 95% CI, 1.14-2.27, I2=80%).

conclusionHigh BMI increases liver cancer mortality and occurrence of primary liver cancer. Obesity is an independent risk factor for the occurrence of and mortality from primary liver cancer.

Indexed as

Liver NeoplasmsObesityBody Mass IndexHumansMaleOverweightProspective StudiesRisk FactorsCarcinoma, HepatocellularLiver cancerMortalityObesityRisk

Identifiers

PMID33238333
PMCPMC7820201
OpenAlexW3107494356

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.