학술논문
The beneficial impact of metabolic dysfunction‐associated fatty liver disease on lenvatinib treatment in patients with non‐viral hepatocellular carcinoma.
Document Type
Article
Author
Shimose, Shigeo; Hiraoka, Atsushi; Casadei‐Gardini, Andrea; Tsutsumi, Tsubasa; Nakano, Dan; Iwamoto, Hideki; Tada, Fujimasa; Rimini, Margherita; Tanaka, Masatoshi; Torimura, Takuji; Suga, Hideya; Ohama, Hideko; Burgio, Valentina; Niizeki, Takashi; Moriyama, Etsuko; Suzuki, Hiroyuki; Shirono, Tomotake; Noda, Yu; Kamachi, Naoki; Nakano, Masahito
Source
Subject
*FATTY liver
*HEPATOCELLULAR carcinoma
*THERAPEUTICS
*DISEASE risk factors
*LIVER cancer
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Language
ISSN
1386-6346
Abstract
Aim: Lenvatinib is used to treat advanced hepatocellular carcinoma (HCC). Metabolic dysfunction‐associated fatty liver disease (MAFLD) is becoming a major etiology of HCC. We aimed to evaluate the impact of MAFLD on the efficacy of lenvatinib. Methods: We enrolled 320 patients with HCC who were treated with lenvatinib. All patients were classified into the MAFLD (n = 155) and non‐MAFLD (n = 165) groups. Independent factors for overall survival (OS) were analyzed. In the stratification analysis, HCC was categorized as non‐viral (n = 115) or viral HCC (n = 205). Results: The OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group (median 21.1 vs. 15.1 months, p = 0.002). Multivariate analysis demonstrated that, in addition to albumin‐bilirubin grade and Barcelona Clinic Liver Cancer stage, MAFLD was identified as an independent factor for OS (HR 0.722, 95% CI 0.539–0.966, p = 0.028). In the stratification analysis, the OS rate was significantly higher in the MAFLD group than in the non‐MAFLD group among patients with non‐viral HCC (median 21.1 vs. 15.1 months, p = 0.002), but not in patients with viral HCC. Furthermore, MAFLD was an independent negative risk factor for OS in patients with non‐viral HCC (HR 0.506, 95% CI 0.297–0.864, P < 0.01). However, MAFLD was not an independent factor for OS in patients with viral HCC. Conclusions: MAFLD was a beneficial factor for survival in patients with HCC treated with lenvatinib. Moreover, the better OS of the MAFLD group was more pronounced in patients with non‐viral HCC. Lenvatinib may be a suitable agent for patients with non‐viral HCC and MAFLD. [ABSTRACT FROM AUTHOR]