Clinical features and outcomes of NAFLD-related hepatocellular carcinoma – Authors' reply

We appreciate the interest from Lei Liu and Rui Liao in our Article. 1 Tan DJH Ng CH Lin SY et al. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysis. Lancet Oncol. 2022; 23: 521-530 Summary Full Text Full Text PDF PubMed Scopus (72) Google Scholar They highlighted the relative scarcity of comparative data regarding non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma versus hepatocellular carcinoma from other causes from mainland China. We agree that it remains important to track the epidemiology and outcomes of NAFLD-related hepatocellular carcinoma in China, given the changing epidemiology of liver disease in the region. 2 Huang DQ El-Serag HB Loomba R Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2021; 18: 223-238 Crossref PubMed Scopus (615) Google Scholar There was a paucity of cohort studies from mainland China that fulfilled the predefined inclusion criteria in our study. Given the increasing availability of antiviral therapy for hepatitis B virus, we anticipate that the comparative survival outcomes between NAFLD-related hepatocellular carcinoma and hepatitis B virus-related hepatocellular carcinoma might change over time. 3 Huang DQ Li X Le MH et al. Natural history and hepatocellular carcinoma risk in untreated chronic hepatitis B patients with indeterminate phase. Clin Gastroenterol Hepatol. 2021; (published online Jan 16.)https://doi.org/10.1016/j.cgh.2021.01.019 Summary Full Text Full Text PDF Scopus (30) Google Scholar , 4 Huang DQ Hoang JK Leong J et al. Differential characteristics and outcomes of Asian and non-Asian patients with HBV-related hepatocellular carcinoma. Liver Int. 2021; 41: 1922-1932 Crossref PubMed Scopus (12) Google Scholar More data from mainland China, where hepatitis B virus is endemic, will be helpful to evaluate this. In addition, we want to highlight that there was an absence of data from Africa and the eastern Mediterranean region; therefore, more studies are urgently required from these regions as well. Clinical characteristics, surveillance, treatment allocation, and outcomes of non-alcoholic fatty liver disease-related hepatocellular carcinoma: a systematic review and meta-analysisNAFLD-related hepatocellular carcinoma is associated with a higher proportion of patients without cirrhosis and lower surveillance rates than hepatocellular carcinoma due to other causes. Surveillance strategies should be developed for patients with NAFLD without cirrhosis who are at high risk of developing hepatocellular carcinoma. Full-Text PDF Open AccessClinical features and outcomes of NAFLD-related hepatocellular carcinomaIn The Lancet Oncology, Darren Jun Hao Tan and colleagues1 investigated the clinical features and outcomes of non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma worldwide. However, this systematic review and meta-analysis warrant further elaboration of some aspects. Full-Text PDF