ArticleHepatology international2026
A comprehensive evaluation on the impact of MASLD on the prognosis of chronic hepatitis B-related hepatocellular carcinoma following hepatectomy: results from retrospective multicenter cohort study and meta-analysis.
Article in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrognosis after radical hepatectomy for chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) is poor. Comorbidity of CHB and metabolic dysfunction-associated steatotic liver disease (MASLD) has grown increasingly common, with MASLD further modifying the hepatic microenvironment beyond HBV-induced injury. However, its impact on postoperative prognosis remains unclear.
methodsCombining a retrospective study with meta-analysis, this study systematically compared prognostic differences and influencing factors in 424 hepatectomy patients (MASLD-CHB-HCC group vs. CHB-HCC group) from multiple centers. Additionally, a meta-analysis involving 6653 patients was performed to further verify the prognostic effect of MASLD.
resultsIn this retrospective cohort study, the MASLD-CHB-HCC group showed significantly superior overall survival (OS) (p = 0.041) and recurrence-free survival (RFS) (p = 0.028) compared with the CHB-HCC group, with statistically significant differences. However, after performing propensity score matching (PSM) screening, no statistical differences were observed in OS (p = 0.220) and RFS (p = 0.190) between the two groups. This result is consistent with our meta-analysis conclusion. Cox regression analysis demonstrated that higher body mass index (BMI) was an independent factor associated with favorable survival. In subgroup analyses stratified by different BMI cutoffs, among non-lean patients, the MASLD-CHB-HCC group achieved better OS (BMI ≥ 23 subgroup: p < 0.001; BMI ≥ 25 subgroup: p < 0.001) and RFS (BMI ≥ 23 subgroup: p < 0.001; BMI ≥ 25 subgroup: p < 0.001).
conclusionsMASLD exerts differential impacts on survival prognosis in patients with CHB-HCC, with divergent effects observed between lean and non-lean subgroups stratified by BMI.
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