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.

Authors

Yiyu Chen, Yangyang Ou, Kang Chen, Tianyi Liang, Jiayong Su, Xinping Ye, Liang Ma, Ming Yao, Junjiang Guo, Liang Liang, Jianjun Li, Yuanneng Nong, Ji An Chen, Fei Huang, Tao Peng, Jian-Hong Zhong, Yihe Yan

Published in

Hepatology international. Oct 14, 2026. Epub Oct 14, 2026.

Abstract

Prognosis 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.
Combining 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.
In 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).
MASLD exerts differential impacts on survival prognosis in patients with CHB-HCC, with divergent effects observed between lean and non-lean subgroups stratified by BMI.

PMID:
42873449
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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