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Purpose of Review <p>There is a rising global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its role in hepatocellular carcinoma (HCC). It aims to summarize risk factors, prediction models, screening guidelines, mechanisms driving progression from metabolic dysfunction-associated steatohepatitis (MASH) to HCC, and current management strategies.</p> Recent Findings <p>Emerging evidence highlights risk factors such as obesity, diabetes mellitus, age, sex, and ethnicity, alongside genetic contributions to HCC progression. Mechanistic pathways involve lipid accumulation, lipotoxicity, metabolic reprogramming, oxidative stress, and immune dysregulation. While current screening guidelines focus on patients with cirrhosis or advanced fibrosis, a substantial proportion of MASLD-related HCC arises in non-cirrhotic patients, emphasizing a need for improved risk stratification.</p> Summary <p>MASLD-related HCC survival outcomes and treatment approaches are comparable to other etiologies. Future research should refine screening strategies for non-cirrhotic patients, validate predictive models, and explore tailored therapies, addressing gaps in early detection and immune-based treatments for this growing population.</p>

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Hepatocellular Carcinoma in the Setting of Metabolic Dysfunction Associated Steatotic Liver Disease

  • 期刊论文

  • 发表日期：

    2026年3月2日

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  • Amanda Su,
  • Jeanne M. Clark,
  • Amy K. Kim

摘要

Purpose of Review

There is a rising global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its role in hepatocellular carcinoma (HCC). It aims to summarize risk factors, prediction models, screening guidelines, mechanisms driving progression from metabolic dysfunction-associated steatohepatitis (MASH) to HCC, and current management strategies.

Recent Findings

Emerging evidence highlights risk factors such as obesity, diabetes mellitus, age, sex, and ethnicity, alongside genetic contributions to HCC progression. Mechanistic pathways involve lipid accumulation, lipotoxicity, metabolic reprogramming, oxidative stress, and immune dysregulation. While current screening guidelines focus on patients with cirrhosis or advanced fibrosis, a substantial proportion of MASLD-related HCC arises in non-cirrhotic patients, emphasizing a need for improved risk stratification.

Summary

MASLD-related HCC survival outcomes and treatment approaches are comparable to other etiologies. Future research should refine screening strategies for non-cirrhotic patients, validate predictive models, and explore tailored therapies, addressing gaps in early detection and immune-based treatments for this growing population.