Abstract
The burden of chronic liver diseases including hepatocellular carcinoma (HCC) due to non-alcoholic steatohepatitis (NASH) and metabolic syndrome (MS) is increasing worldwide. Moreover, MS and its components act as co-factors in HCC development in patients with other chronic liver diseases due to high alcohol intake or hepatitis B or C infection. Patients with NASH-related HCC are frequently older; their tumors are more frequently diagnosed in non-cirrhotic livers and at an advanced stage compared to HCC due to other etiologies. Patients with MS appear also to be at risk of post-operative complications after liver resection and transplantation. However, after adjustment for tumor burden and severity of the underlying liver disease, long-term outcomes appear to be similar for NASH-related HCC and HCC due to other etiologies. Research on preventive strategies, screening programs for patients with NASH without cirrhosis but at high risk of HCC development, and new therapeutic strategies are warranted in order to respond to this emerging menace.
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