Interactive Roles of Metabolic Dysfunction-Associated Steatotic Liver Disease and Nutritional Status in the Prognosis of Patients With Hepatocellular Carcinoma After Surgical Resection.

Authors

Chun-Ting Ho, Chien-An Liu, Chia-Jung Ho, Yi-Chen Lin, Shin-Yu Tsai, Hao-Jan Lei, Shu-Cheng Chou, Yi-Hsiang Huang, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su

Published in

The Kaohsiung journal of medical sciences. Pages e70256. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

The prognostic effect of concurrent metabolic dysfunction-associated steatotic liver disease (MASLD) on outcomes for hepatocellular carcinoma (HCC) patients remains unclear. The Prognostic Nutritional Index (PNI) reflects nutritional and inflammatory status and is a well-known prognostic factor. We therefore aimed to evaluate and compare the prognostic role of PNI in patients with HCC with and without concurrent MASLD undergoing curative surgical resection. In our retrospective study, 991 patients undergoing curative HCC resection were stratified according to MASLD status and pre-operative PNI (cut-off: 45). Overall survival (OS) and recurrence-free survival (RFS) were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Further subgroup analysis was performed according to their concurrent viral hepatitis status. High PNI was identified as an independent protective factor against poor OS for the entire cohort (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.49-0.87, p = 0.004). The Kaplan-Meier analysis showed that the high-PNI/MASLD group had the best OS, while the low-PNI/no-MASLD group had the worst. Subgroup analysis indicated that high PNI was an independent protective factor for OS only in the no-MASLD group (HR: 0.59, p = 0.003) but not the MASLD group (HR: 0.94, p = 0.793). Its prognostic effect was more significant in HCC patients without concurrent MASLD or with chronic hepatitis B. To conclude, a better nutritional status, assessed by PNI, is a valuable prognostic marker for patients with HCC. Its protective effect on OS is significantly pronounced in patients without concurrent MASLD, indicating that MASLD status modifies the prognostic utility of PNI.

PMID:
42400215
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.