Impact of Steatotic Liver Disease on Survival Outcomes Following Resection for HBV/HCV-Related Hepatocellular Carcinoma in Mongolia
1
Epidemiology and Biostatistics, Mongolian National University of Medical Sciences, ULAANBAATAR, Mongolia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Hepatocellular carcinoma (HCC) is a major health burden in Mongolia, having the highest incidence, predominantly driven by chronic viral hepatitis. The contribution of metabolic dysfunction-associated steatohepatitis (MASH-HCC) and alcohol-related liver disease (ALD-HCC) is poorly defined. This study aimed to compare the clinicopathological features and outcomes of HCC arising from MASH versus ALD in Mongolian patients.
METHODS:
This was a retrospective cohort study of 980 HCC patients who underwent liver resection at the National Cancer Center of Mongolia (2015–2018). Patients were categorized as ALD-HCC (n=191) based on heavy alcohol use (≥80g/day) or MASH-HCC (n=789) based on metabolic syndrome, with both groups excluding chronic viral hepatitis as the sole etiology. Clinicopathological variables, including demographics, tumor features, and survival, were compared using appropriate statistical tests.
RESULTS:
ALD-HCC patients were significantly younger (mean age 46–60 years) and overwhelmingly male (96.8%). MASH-HCC patients were older (mean age >61 years) and more prevalent in women (55.6%). MASH-HCC demonstrated a more aggressive tumor profile, characterized by a higher frequency of tumors >5 cm (p=0.0045), poorly differentiated tumors (G3−4, p=0.0248), advanced TNM T4 stage (p=0.0009), and large lymphovascular invasion (p<0.0001). Despite the aggressive tumor biology, MASH-HCC had a significantly longer median overall survival (92.6 months vs. 82.0 months, p=0.0206) but also a significantly higher tumor recurrence rate (p<0.0001) compared to ALD-HCC. Notably, high rates of HBV and HCV co-infection were observed in both groups.
CONCLUSIONS:
MASH-HCC and ALD-HCC represent distinct clinical entities in the Mongolian population. While ALD-HCC affects younger men, MASH-HCC is linked to older women and presents with aggressive tumors. The superior initial survival of MASH-HCC is offset by a dramatically higher recurrence rate, underscoring the need for tailored post-resection surveillance strategies for patients with metabolic syndrome. The high prevalence of viral co-infection highlights a "multiple-hit" model of carcinogenesis in this high-incidence region.
Hepatocellular carcinoma (HCC) is a major health burden in Mongolia, having the highest incidence, predominantly driven by chronic viral hepatitis. The contribution of metabolic dysfunction-associated steatohepatitis (MASH-HCC) and alcohol-related liver disease (ALD-HCC) is poorly defined. This study aimed to compare the clinicopathological features and outcomes of HCC arising from MASH versus ALD in Mongolian patients.
METHODS:
This was a retrospective cohort study of 980 HCC patients who underwent liver resection at the National Cancer Center of Mongolia (2015–2018). Patients were categorized as ALD-HCC (n=191) based on heavy alcohol use (≥80g/day) or MASH-HCC (n=789) based on metabolic syndrome, with both groups excluding chronic viral hepatitis as the sole etiology. Clinicopathological variables, including demographics, tumor features, and survival, were compared using appropriate statistical tests.
RESULTS:
ALD-HCC patients were significantly younger (mean age 46–60 years) and overwhelmingly male (96.8%). MASH-HCC patients were older (mean age >61 years) and more prevalent in women (55.6%). MASH-HCC demonstrated a more aggressive tumor profile, characterized by a higher frequency of tumors >5 cm (p=0.0045), poorly differentiated tumors (G3−4, p=0.0248), advanced TNM T4 stage (p=0.0009), and large lymphovascular invasion (p<0.0001). Despite the aggressive tumor biology, MASH-HCC had a significantly longer median overall survival (92.6 months vs. 82.0 months, p=0.0206) but also a significantly higher tumor recurrence rate (p<0.0001) compared to ALD-HCC. Notably, high rates of HBV and HCV co-infection were observed in both groups.
CONCLUSIONS:
MASH-HCC and ALD-HCC represent distinct clinical entities in the Mongolian population. While ALD-HCC affects younger men, MASH-HCC is linked to older women and presents with aggressive tumors. The superior initial survival of MASH-HCC is offset by a dramatically higher recurrence rate, underscoring the need for tailored post-resection surveillance strategies for patients with metabolic syndrome. The high prevalence of viral co-infection highlights a "multiple-hit" model of carcinogenesis in this high-incidence region.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
