Evidence mapPaperPMID 36932227Full record

ReviewNature reviews. Gastroenterology & hepatology2023

Nonalcoholic steatohepatitis-related hepatocellular carcinoma: pathogenesis and treatment.

Josep M Llovet, Catherine E Willoughby, Amit G Singal, Tim F Greten, Mathias Heikenwälder, Hashem B El-Serag, Richard S Finn, Scott L Friedman

Open access · greenAbstract readReview
In one paragraph

Review in Nature reviews. Gastroenterology & hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 209 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
209citing papers in PubMed, 7 pooled it
69.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

209 citing papers in PubMed, 7 syntheses or guidelines pooled it, 321 citations in OpenAlex.

  1. Pooled it
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  7. Risk factors of hepatocellular carcinoma associated with nonalcoholic fatty liver disease: Systematic review and meta-analysis.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024
    Pooled it
  8. Article
  9. Review
  10. Cancer prevention through metabolic remission.Nature reviews. Endocrinology · 2026
    Article
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149 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 3 countries.

Josep M LlovetMount Sinai Liver Cancer Program, Division of Liver Diseases, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. josep.llovet@mountsinai.org.ORCID 0000-0003-0547-2667
Catherine E WilloughbyTranslational Research in Hepatic Oncology, Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain.ORCID 0000-0002-0617-8833
Amit G SingalDepartment of Internal Medicine, University of Texas Southwestern (UTSW) Medical Centre, Dallas, TX, USA.
Tim F GretenGastrointestinal Malignancy Section, Thoracic and Gastrointestinal Malignancies Branch, Centre for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA.ORCID 0000-0002-0806-2535
Mathias HeikenwälderDivision of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Hashem B El-SeragDepartment of Medicine, Baylor College of Medicine, Houston, TX, USA.ORCID 0000-0001-5964-7579
Richard S FinnDepartment of Medicine, Division of Hematology/Oncology, Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Scott L FriedmanMount Sinai Liver Cancer Program, Division of Liver Diseases, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID 0000-0003-1178-6195
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESGerman Cancer Research Center · DEIcahn School of Medicine at Mount Sinai · USInstitució Catalana de Recerca i Estudis Avançats · ESMichael E. DeBakey VA Medical Center · USNational Institutes of Health · USThe University of Texas Southwestern Medical Center · USUniversity of California, Los Angeles · US

Funding

Clinical protocols for the treatment of gastrointestinal cancerZIABC011343 · DIVISION OF BASIC SCIENCES - NCI · 2025 to 2025
$623k
NIDDK NIH HHS R01 DK128289
6 · The paper itself

Abstract

Nonalcoholic fatty liver disease (NAFLD), including its more severe manifestation, nonalcoholic steatohepatitis (NASH), has a global prevalence of 20-25% and is a major public health problem. Its incidence is increasing in parallel to the rise in obesity, diabetes and metabolic syndrome. Progression from NASH to NASH-related hepatocellular carcinoma (HCC) (~2% of cases per year) is influenced by many factors, including the tissue and immune microenvironment, germline mutations in PNPLA3, and the microbiome. NASH-HCC has unique molecular and immune traits compared with other aetiologies of HCC and is equally prevalent in men and women. Comorbidities associated with NASH, such as obesity and diabetes mellitus, can prevent the implementation of potentially curative therapies in certain patients; nonetheless, outcomes are similar in patients who receive treatment. NASH-HCC at the early to intermediate stages is managed with surgery and locoregional therapies, whereas advanced HCC is treated with systemic therapies, including anti-angiogenic therapies and immune-checkpoint inhibitors. In this Review, we present the latest knowledge of the pathogenic mechanisms and clinical management of NASH-HCC. We discuss data highlighting the controversy over varying responses to immune-checkpoint inhibitors according to underlying aetiology and suggest that the future of NASH-HCC management lies in improved surveillance, targeted combination therapies to overcome immune evasion, and identifying biomarkers to recognize treatment responders.

Indexed as

Carcinoma, HepatocellularDiabetes MellitusLiver NeoplasmsNon-alcoholic Fatty Liver DiseaseDisease ProgressionFemaleHumansImmune Checkpoint InhibitorsMaleObesityTumor MicroenvironmentImmune Checkpoint Inhibitors

Identifiers

PMID36932227
PMCPMC12165718
OpenAlexW4327744345

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.